Bone turnover in long-term survivors of childhood acute lymphoblastic leukemia

Mitchell Aaron Watsky, Laura D Carbone, Qi An, Cheng Cheng, Elizabeth A. Lovorn, Melissa M. Hudson, Ching Hon Pui, Sue C. Kaste

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background: We investigated the effects of demographic, lifestyle (self-reported smoking status and physical activity levels), cancer-related treatment factors (radiation and chemotherapy), and diet (calcium and vitamin D intake) on bone turnover and the relationship of bone turnover to lumbar spine bone mineral density (BMD) Z-scores (LS-BMD Z-scores) determined by quantitative computed tomography (QCT) in 418 ≥5-year survivors of childhood acute lymphoblastic leukemia (ALL). Procedure: Bone turnover was assessed by biomarkers including serum bone-specific alkaline phosphatase (BALP), osteocalcin (OC), and urinary N-telopeptide of type I collagen indexed to creatinine (NTX/Cr). The 215 males ranged in age from 9 to 36 years (median age 17 years). Results: Age and tanner score were inversely associated with all biomarkers (BALP, OC, NTX/Cr) (P<0.001). Males had higher BALP and OC than females (P<0.001). Body mass index (BMI) was inversely associated with OC and NTX/Cr (P<0.001). There was no significant association of biomarkers with lifestyle related factors, ALL treatment-related factors, dietary calcium, vitamin D, or LS-BMD Z-score. Conclusions: In this population of long-term survivors of ALL, bone turnover was significantly associated with age, gender, tanner stage, and BMI. ALL-related treatments did not influence bone turnover and bone turnover was not predictive of volumetric LS-BMD Z-score.

Original languageEnglish (US)
Pages (from-to)1451-1456
Number of pages6
JournalPediatric Blood and Cancer
Volume61
Issue number8
DOIs
StatePublished - Jan 1 2014

Fingerprint

Bone Remodeling
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Survivors
Osteocalcin
Bone Density
Alkaline Phosphatase
Bone and Bones
Biomarkers
Vitamin D
Life Style
Body Mass Index
Dietary Calcium
Second Primary Neoplasms
Collagen Type I
Creatinine
Spine
Smoking
Tomography
Demography
Exercise

Keywords

  • Acute lymphoblastic leukemia survivors
  • Bone biomarkers
  • Bone mineral density
  • QCT

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Hematology
  • Oncology

Cite this

Bone turnover in long-term survivors of childhood acute lymphoblastic leukemia. / Watsky, Mitchell Aaron; Carbone, Laura D; An, Qi; Cheng, Cheng; Lovorn, Elizabeth A.; Hudson, Melissa M.; Pui, Ching Hon; Kaste, Sue C.

In: Pediatric Blood and Cancer, Vol. 61, No. 8, 01.01.2014, p. 1451-1456.

Research output: Contribution to journalArticle

Watsky, Mitchell Aaron ; Carbone, Laura D ; An, Qi ; Cheng, Cheng ; Lovorn, Elizabeth A. ; Hudson, Melissa M. ; Pui, Ching Hon ; Kaste, Sue C. / Bone turnover in long-term survivors of childhood acute lymphoblastic leukemia. In: Pediatric Blood and Cancer. 2014 ; Vol. 61, No. 8. pp. 1451-1456.
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AB - Background: We investigated the effects of demographic, lifestyle (self-reported smoking status and physical activity levels), cancer-related treatment factors (radiation and chemotherapy), and diet (calcium and vitamin D intake) on bone turnover and the relationship of bone turnover to lumbar spine bone mineral density (BMD) Z-scores (LS-BMD Z-scores) determined by quantitative computed tomography (QCT) in 418 ≥5-year survivors of childhood acute lymphoblastic leukemia (ALL). Procedure: Bone turnover was assessed by biomarkers including serum bone-specific alkaline phosphatase (BALP), osteocalcin (OC), and urinary N-telopeptide of type I collagen indexed to creatinine (NTX/Cr). The 215 males ranged in age from 9 to 36 years (median age 17 years). Results: Age and tanner score were inversely associated with all biomarkers (BALP, OC, NTX/Cr) (P<0.001). Males had higher BALP and OC than females (P<0.001). Body mass index (BMI) was inversely associated with OC and NTX/Cr (P<0.001). There was no significant association of biomarkers with lifestyle related factors, ALL treatment-related factors, dietary calcium, vitamin D, or LS-BMD Z-score. Conclusions: In this population of long-term survivors of ALL, bone turnover was significantly associated with age, gender, tanner stage, and BMI. ALL-related treatments did not influence bone turnover and bone turnover was not predictive of volumetric LS-BMD Z-score.

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