Conflict of interest: Nothing to declare.
Bone turnover in long-term survivors of childhood acute lymphoblastic leukemia
Article first published online: 20 MAR 2014
© 2014 Wiley Periodicals, Inc.
Pediatric Blood & Cancer
Volume 61, Issue 8, pages 1451–1456, August 2014
How to Cite
Watsky, M. A., Carbone, L. D., An, Q., Cheng, C., Lovorn, E. A., Hudson, M. M., Pui, C.-H. and Kaste, S. C. (2014), Bone turnover in long-term survivors of childhood acute lymphoblastic leukemia. Pediatr. Blood Cancer, 61: 1451–1456. doi: 10.1002/pbc.25025
- Issue published online: 10 JUN 2014
- Article first published online: 20 MAR 2014
- Manuscript Accepted: 12 FEB 2014
- Manuscript Received: 16 JAN 2014
- National Institutes of Health. Grant Number: P30 CA-21765
- State of Tennessee
- American Lebanese Syrian Associated Charities (ALSAC)
- acute lymphoblastic leukemia survivors;
- bone biomarkers;
- bone mineral density;
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).
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).
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.
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.