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Identification of non-Hodgkin lymphoma patients at risk for treatment-related vertebral density loss and fractures
SUMMARY: Information on bone loss in treated non-Hodgkin’s lymphoma patients is limited. In this study, we used CT to analyze bone loss as well as prevalent and incident fractures. We found severe bone loss, a high rate of fractures, and a novel association between bone loss and the international pr...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer London
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7838070/ https://www.ncbi.nlm.nih.gov/pubmed/32803319 http://dx.doi.org/10.1007/s00198-020-05577-9 |
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author | Bodden, J. Sun, D. Joseph, G. B. Huang, L.-W. Andreadis, C. Hughes-Fulford, M. Lang, T. F. Link, T. M. |
author_facet | Bodden, J. Sun, D. Joseph, G. B. Huang, L.-W. Andreadis, C. Hughes-Fulford, M. Lang, T. F. Link, T. M. |
author_sort | Bodden, J. |
collection | PubMed |
description | SUMMARY: Information on bone loss in treated non-Hodgkin’s lymphoma patients is limited. In this study, we used CT to analyze bone loss as well as prevalent and incident fractures. We found severe bone loss, a high rate of fractures, and a novel association between bone loss and the international prognostic index. INTRODUCTION: To investigate bone loss and fracture risk in non-Hodgkin-lymphoma (NHL) patients by (i) comparing treatment-related vertebral density (VD) loss in NHL patients with control subjects and (ii) investigating associations of VD loss versus fracture risk. Further, associations of VD loss and clinical parameters were investigated. METHODS: VD of 123 NHL patients was measured pre- and post-treatment in the L1, L2, and L3 vertebrae in routine computed tomography (CT) scans, performed between Jan 2016 and Mar 2017. Control measurements (n = 52) were obtained from CT colonographies between Sept 2003 and Sept 2017 and their subsequent follow-up-exams (10–137 months). Prevalent and incident (between baseline and follow-up) fractures were assessed in all subjects, and VD loss per year was calculated. Linear regression models were used to (i) compare VD loss between patients and controls and (ii) identify associations between VD loss and clinical parameters. Using logistic regression models, ORs for fractures per SD change in VD were assessed in patients. Analyses were adjusted for age, sex, and contrast application. RESULTS: NHL patients experienced significantly greater VD(L1–3) loss than controls (P = 0.003), and greater VD(L1–3) loss was associated with a greater likelihood of incident fractures (OR, [95%-CI], P 1.90, [1.03, 3.51], 0.04). Patients with an initial international prognostic index (IPI) of 5 suffered significantly greater VD loss compared with an IPI of 0 (P = 0.01). CONCLUSION: Using VD measurements in routine CT scans, substantial vertebral bone loss in NHL patients could be documented with a high incidence of fractures. |
format | Online Article Text |
id | pubmed-7838070 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Springer London |
record_format | MEDLINE/PubMed |
spelling | pubmed-78380702021-02-01 Identification of non-Hodgkin lymphoma patients at risk for treatment-related vertebral density loss and fractures Bodden, J. Sun, D. Joseph, G. B. Huang, L.-W. Andreadis, C. Hughes-Fulford, M. Lang, T. F. Link, T. M. Osteoporos Int Original Article SUMMARY: Information on bone loss in treated non-Hodgkin’s lymphoma patients is limited. In this study, we used CT to analyze bone loss as well as prevalent and incident fractures. We found severe bone loss, a high rate of fractures, and a novel association between bone loss and the international prognostic index. INTRODUCTION: To investigate bone loss and fracture risk in non-Hodgkin-lymphoma (NHL) patients by (i) comparing treatment-related vertebral density (VD) loss in NHL patients with control subjects and (ii) investigating associations of VD loss versus fracture risk. Further, associations of VD loss and clinical parameters were investigated. METHODS: VD of 123 NHL patients was measured pre- and post-treatment in the L1, L2, and L3 vertebrae in routine computed tomography (CT) scans, performed between Jan 2016 and Mar 2017. Control measurements (n = 52) were obtained from CT colonographies between Sept 2003 and Sept 2017 and their subsequent follow-up-exams (10–137 months). Prevalent and incident (between baseline and follow-up) fractures were assessed in all subjects, and VD loss per year was calculated. Linear regression models were used to (i) compare VD loss between patients and controls and (ii) identify associations between VD loss and clinical parameters. Using logistic regression models, ORs for fractures per SD change in VD were assessed in patients. Analyses were adjusted for age, sex, and contrast application. RESULTS: NHL patients experienced significantly greater VD(L1–3) loss than controls (P = 0.003), and greater VD(L1–3) loss was associated with a greater likelihood of incident fractures (OR, [95%-CI], P 1.90, [1.03, 3.51], 0.04). Patients with an initial international prognostic index (IPI) of 5 suffered significantly greater VD loss compared with an IPI of 0 (P = 0.01). CONCLUSION: Using VD measurements in routine CT scans, substantial vertebral bone loss in NHL patients could be documented with a high incidence of fractures. Springer London 2020-08-15 2021 /pmc/articles/PMC7838070/ /pubmed/32803319 http://dx.doi.org/10.1007/s00198-020-05577-9 Text en © The Author(s) 2020 Open Access This article is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, which permits any non-commercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc/4.0/. |
spellingShingle | Original Article Bodden, J. Sun, D. Joseph, G. B. Huang, L.-W. Andreadis, C. Hughes-Fulford, M. Lang, T. F. Link, T. M. Identification of non-Hodgkin lymphoma patients at risk for treatment-related vertebral density loss and fractures |
title | Identification of non-Hodgkin lymphoma patients at risk for treatment-related vertebral density loss and fractures |
title_full | Identification of non-Hodgkin lymphoma patients at risk for treatment-related vertebral density loss and fractures |
title_fullStr | Identification of non-Hodgkin lymphoma patients at risk for treatment-related vertebral density loss and fractures |
title_full_unstemmed | Identification of non-Hodgkin lymphoma patients at risk for treatment-related vertebral density loss and fractures |
title_short | Identification of non-Hodgkin lymphoma patients at risk for treatment-related vertebral density loss and fractures |
title_sort | identification of non-hodgkin lymphoma patients at risk for treatment-related vertebral density loss and fractures |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7838070/ https://www.ncbi.nlm.nih.gov/pubmed/32803319 http://dx.doi.org/10.1007/s00198-020-05577-9 |
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