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

Authors

  • Mitchell A. Watsky PhD,

    1. Department of Cell Biology & Anatomy, Georgia Regents University, Augusta, Georgia
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  • Laura D. Carbone MD,

    1. Department of Medicine, Georgia Regents University, Augusta, Georgia
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  • Qi An MS,

    1. Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, Tennessee
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  • Cheng Cheng PhD,

    1. Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, Tennessee
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  • Elizabeth A. Lovorn,

    1. Department of Radiological Sciences, St. Jude Children's Research Hospital, Memphis, Tennessee
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  • Melissa M. Hudson MD,

    1. Department of Pediatrics, University of Tennessee Health Science Center, Memphis, Tennessee
    2. Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee
    3. Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee
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  • Ching-Hon Pui MD,

    1. Department of Pediatrics, University of Tennessee Health Science Center, Memphis, Tennessee
    2. Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee
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  • Sue C. Kaste DO

    Corresponding author
    1. Department of Radiological Sciences, St. Jude Children's Research Hospital, Memphis, Tennessee
    2. Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee
    3. Department of Radiology, University of Tennessee Health Science Center, Memphis, Tennessee
    • Correspondence to: Sue C. Kaste, Department of Radiological Sciences, 262 Danny Thomas Place, MS #220, Memphis, TN 38105.

      E-mail: skaste@stjude.org

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  • Conflict of interest: Nothing to declare.

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. Pediatr Blood Cancer 2014; 61:1451–1456. © 2014 Wiley Periodicals, Inc.

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