Reductions in Bone Mineral Density Are Apparent Early in Children With Prevalent Osteonecrosis Lesions Following Leukemia Therapy
Authors' conclusion
Overall, one-third of children demonstrated ON after leukemia therapy. Those with ON had greater reductions in spine and hip BMD Z-scores in the first 1 and 2 years of therapy, respectively. Older age and lower hip BMD Z-scores at MRI were significantly associated with prevalent, off-therapy ON.
Study context
- Population
- Children with acute lymphoblastic leukemia enrolled in the STOPP study, evaluated by magnetic resonance imaging (MRI) 3.1 ± 1.3 years following therapy
- Participants
- 86 children
- Exposure
- Children with vs without osteonecrosis (ON)
- ONn = 30
- Without ONn = 56reference
- Outcome
- Prevalence of osteonecrotic lesions on MRI
- Follow-up
- >1 year following leukemia therapy
Methodological detailsone-time multisite MRI, within STOPP study
- One-time multisite MRI
- Within STOPP study
Main finding
As reported in the abstract
Prevalence of ON · 3.1 ± 1.3 years following therapy
Children with confirmed ON lesions
30
35%
Total confirmed ON lesions
150
Observational data: associations, not effects.
Further findings
Pain
P = 0.841
Mean
| Outcome | ON | Without ON | P value |
|---|---|---|---|
| LS BMD Z-score at diagnosis | −1.09 (SD 1.53) | −1.27 (SD 1.25) | P = 0.549 |
| Change in LS BMD Z-score · baseline to 12 months | −0.31 (SD 1.02) | 0.13 (SD 0.82) | P = 0.035 |
| Change in hip BMD Z-score · baseline to 24 months | −1.77 (SD 1.22) | −1.03 (SD 1.07) | P = 0.045 |
| Total hip BMD Z-score at MRI · time of MRI | −0.98 (SD 0.95) | −0.28 (SD 1.06) | P = 0.010 |
| TB BMD Z-score at MRI · time of MRI | −1.36 (SD 1.10) | −0.48 (SD 1.50) | P = 0.018 |
Factors independently associated with ON (multivariable models)
- Older age at diagnosis: OR
- 1.57 (95% CI 1.15-2.13; p = 0.004)
- Hip BMD Z-score at MRI: OR
- 2.23 (95% CI 1.02-4.87; p = 0.046)
Original publication
Reductions in Bone Mineral Density Are Apparent Early in Children With Prevalent Osteonecrosis Lesions Following Leukemia Therapy. J Bone Miner Res. Published 10 July 2023. doi:10.
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