ASSESSMENT OF BONE MINERAL DENSITY IN PATIENTS WITH HODGKIN’S LYMPHOMA
https://doi.org/10.15372/SSMJ20190106
Abstract
Currently, Hodgkin’s lymphoma (HL) is considered as a potentially curable disease. The polychemotherapy including various combinations of cytostatic drugs and glucocorticoids appears the standard of treatment in patients with HL. Patients with early stage disease (stage I to II) receive several cycles of chemotherapy followed by the radiotherapy. The possibility of achieving persistent disease-free survival poses a problem of ensuring a satisfactory quality of life and preventing the long-term consequences of antitumor therapy. One of those consequences may be a change in bone mineral density (BMD). Aim of the study was to assess the BMD in patients with HL. Material and methods. BMD was measured by dual-energy X-ray absorbtiometry using a stationary LunarProdigy bone densitometer (GE, USA). The Russian FRAX model was used in this study. The model uses clinical data to calculate the major low-energy fractures and the hip fractures. Results. The decreased BMD was revealed in 36 observed HL subjects (48.6 %). Patients with osteoporosis were generally older, had a lower body mass index as compared to patients with normal BMD (p < 0.05). Based on FRAX assessment, the 10-year risk of major low-energy fractures and the hip fractures was expectedly higher in patients with osteoporosis and osteopenia as compared to subjects with normal BMD (p < 0.05). More patients with radiotherapy in anamnesis had decreased BMD compared to patients who received chemotherapy only (χ2 = 5.47; р = 0.0194). More than half of the patients (59.1 %) receiving regimens containing glucocorticosteroids had BMD decrease. A comparative analysis revealed that patients younger than 50 years old had lower values of BMD and Z-score of the lumbar spine in the early stages of HL as compared to patients with stage III-IV. In turn, in patients older 50 years and postmenopausal women at the early stages of HL was a significant decrease of BMD and T-score of the femoral neck as compared to patients with advanced stages of the disease. This research suggests that the decrease in BMD in stages I-II of HL can be associated with radiotherapy as the generally accepted standard for the treatment of early stages of the disease.
About the Authors
M. S. Voytko
Novosibirsk State Medical University of Minzdrav of Russia
Russian Federation
Russian Federation
Mariya Sergeevna VOYTKO – postgraduate student of the department of therapy, hematology and blood transfusion
630091, Novosibirsk, Krasny av., 52
T. I. Pospelova
Novosibirsk State Medical University of Minzdrav of Russia
Russian Federation
Russian Federation
Tatyana Ivanovna POSPELOVA – doctor of medical sciences, professor, head of the department of therapy, hematology and blood transfusion, prorector for science
630091, Novosibirsk, Krasny av., 52
V. V. Klimontov
Novosibirsk State Medical University of Minzdrav of Russia;
Research Institute of Clinical and Experimental Lymphology – Branch of the Institute of Cytology and Genetics of SB RAS
Russian Federation
Russian Federation
Vadim Valerievich KLIMONTOV – doctor of medical sciences, professor of the RAS, deputy director for science, head of the laboratory of endocrinology
630091, Novosibirsk, Krasny av., 52; 630117, Novosibirsk, Arbuzov str., 6
O. N. Fazullina
Research Institute of Clinical and Experimental Lymphology – Branch of the Institute of Cytology and Genetics of SB RAS
Russian Federation
Russian Federation
Olga Nikolaevna FAZULLINA – junior researcher
630117, Novosibirsk, Arbuzov str., 6
E. V. Mezit
Novosibirsk State Medical University of Minzdrav of Russia
Russian Federation
Russian Federation
Elena Viktorovna MEZIT – postgraduate student of the department of therapy, hematology and blood transfusion
630091, Novosibirsk, Krasny av., 52
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