The Association of Oral Vitamin D and Calcium Supplementation With Bone Mineral Density in Pediatric Acute Lymphoblastic Leukemia Patients

Demırsoy, Uğur; Sarper, Nazan; Gelen, Sema Aylan; Zengin, Emine; Kum, Tuğba; Demır, Hakan

doi:10.1097/mph.0000000000000797

Cited by 13 publications

(19 citation statements)

References 26 publications

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“…Gunes, et al [9] reported that low calcium and vitamin D intake could have provided to an abnormal bone mineralization in patients undergoing treatment of ALL and they recommend prophylactic vitamin D to patients in the first two years of treatment which was found the most critical period for BMD decrease [9]. In contrast with this study, Diaz, et al [10] and Demirsoy, et al [11] reports found that there was not any significant between the calcium-vitamin D supplementation and BMD.…”

Section: Discussioncontrasting

confidence: 54%

Untitled

2021

Int J Blood Res Disord

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Section: Discussioncontrasting

confidence: 54%

Untitled

2021

Int J Blood Res Disord

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“…Studies of vitamin D/calcium supplementation in children with juvenile rheumatoid arthritis or idiopathic juvenile osteoporosis have shown improvement in BMD and a decreased fracture rate . Some retrospective studies in survivors have shown higher BMD in patients taking vitamin D/calcium supplements, but a randomized trial showed no difference in mean BMD change between survivors assigned to vitamin D/calcium supplementation versus placebo . Further studies are needed to inform interventions for survivors with reduced BMD.…”

Section: Discussionmentioning

confidence: 99%

Severity of reduced bone mineral density and risk of fractures in long‐term survivors of childhood leukemia and lymphoma undergoing guideline‐recommended surveillance for bone health

Bloomhardt

Sint

Ross

et al. 2019

Cancer

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Background Survivors of childhood leukemia/lymphoma are at increased risk for reduced bone mineral density (BMD). The authors sought to determine the frequency of reduced BMD detected by off‐therapy surveillance, factors associated with reduced BMD, and the association of reduced BMD with fractures. Methods This cross‐sectional study included childhood leukemia/lymphoma survivors attending 2 survivorship clinics who received guideline‐recommended BMD surveillance ≥2 years post‐therapy with dual‐energy x‐ray absorptiometry (from January 1, 2004 to August 31, 2016). Lumbar spine BMD z‐scores were height‐for‐age–adjusted. Low and very low BMD were >1 SD and >2 SDs below norms, respectively. Treatment, chronic conditions, and fractures were abstracted from medical records. Logistic regression was used to examine the association of low BMD with patient/treatment factors and fractures. Results In total, 542 patients (51.5% female) with a mean age of 15.5 years (range, 4.4‐52.2 years) who were 6 years post‐therapy (range, 2.0‐35.1 years) were evaluated, including 116 who reported post‐therapy fractures. Lumbar spine low BMD was identified in 17.2% of survivors, and very low BMD was identified in 3.5% of survivors, but frequencies varied considerably between subgroups; 10.8% of survivors aged 15 to 19 years at diagnosis had very low BMD. In multivariable analyses, older age at diagnosis, white race, and being underweight were significantly associated with low BMD. Survivors with low BMD had greater odds of nondigit fractures (odds ratio, 2.2; 95% CI, 1.3‐3.7) and specifically long‐bone fractures (odds ratio, 2.7; 95% CI, 1.5‐4.7). Conclusions In this study of childhood leukemia/lymphoma survivors undergoing guideline‐recommended dual‐energy x‐ray absorptiometry surveillance, patients who were older at diagnosis, white, and underweight were at the highest risk for lumbar spine low BMD. Low BMD was associated with a greater risk of fractures, emphasizing the clinical importance of surveillance.

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“…A randomized double-blind study showed that nutritional counseling and vitamin D and calcium supplementation for 2 years offered no benefit for improving BMD among adolescent and young adult survivors of ALL [46]. Recently, a similar result was reported from a Turkish study group [47]. Depending on these findings, alternative and more aggressive strategies are needed to prevent these patients from experiencing bone complications.…”

Section: Discussionmentioning

confidence: 85%

Investigation of the Relationship Between Fok1 and Col1A1 Gene Polymorphisms and Development of Treatment-Related Bone Complications in Children with Acute Lymphoblastic Leukemia

Erdem

Tüfekçi

Kızıldağ

et al. 2019

Tjh

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Objective: In acute lymphoblastic leukemia (ALL), various clinical risk factors and genetic predispositions contribute to the development of bone complications during and after chemotherapy. In this study, we aimed to investigate whether vitamin D receptor ( VDR ) Fok1 and collagen protein Col1A1 Sp1-binding site gene polymorphisms, which are important in bone mineral and matrix formation, have effects on the development of bone abnormalities in childhood ALL survivors. Materials and Methods: Fifty children with ALL who were treated with the ALL Berlin-Frankfurt-Muenster-95 protocol between 1998 and 2008 and were followed for at least 7 years were enrolled. The control group consisted of 96 healthy children. VDR Fok1 and Col1A1 Sp1-binding site gene polymorphisms were analyzed by polymerase chain reaction and restriction fragment length polymorphism. Bone mineral density (BMD) and markers of bone metabolism were all noted. All patients who presented with pain in the joints were examined for bone pathologies while on chemotherapy or during long-term follow-up. Results: Low BMD (16%), osteoporosis (12%), and osteonecrosis (8%) were present in a total of 18 patients (36%). The frequency of osteonecrosis and total bone abnormalities was significantly higher in children aged ≥10 years (p=0.001). The risk of low BMD and osteonecrosis was higher in those with vitamin D deficiency. Only the Col1A1 Sp1-binding site gene polymorphism showed a significant association in ALL patients with osteonecrosis. Conclusion: The development of therapy-induced bone mineral loss and osteonecrosis in children with ALL is frequent and the risk is especially higher in children aged ≥10 years and with vitamin D deficiency. The association between Col1A1 Sp1-binding site gene polymorphisms and osteonecrosis has to be assessed in a larger group of ALL survivors.

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The Association of Oral Vitamin D and Calcium Supplementation With Bone Mineral Density in Pediatric Acute Lymphoblastic Leukemia Patients

Cited by 13 publications

References 26 publications

Untitled

Untitled

Severity of reduced bone mineral density and risk of fractures in long‐term survivors of childhood leukemia and lymphoma undergoing guideline‐recommended surveillance for bone health

Investigation of the Relationship Between Fok1 and Col1A1 Gene Polymorphisms and Development of Treatment-Related Bone Complications in Children with Acute Lymphoblastic Leukemia

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