Predictors of bone loss in childhood hematologic malignancies: a prospective study

Fuleihan, Ghada El‐Hajj; Muwakkit, Samar; Arabi, Asma; Daouk, L. E.-O.; Ghalayini, T.; Chaiban, Joumana; Abboud, Miguel R.

doi:10.1007/s00198-011-1605-2

Cited by 16 publications

(11 citation statements)

References 28 publications

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“…Duncan et al [9] followed 67 pediatric HSCT patients and found that 37% were deficient at baseline, but in the subgroup of patients !11 years old, 67% were deficient, a figure that accords with our findings (69%). HSCT patients are more prone to develop hypovitaminosis D as a result of sun avoidance, hospitalization, corticosteroid treatment, and diminished intestinal uptake affected by GVHD and bacterial overgrowth [9,[25][26][27]. The lowest baseline levels in our study were found in patients who underwent transplants during winter, spring, and early summerdthat is, before opportunities for sun exposure in northern latitudes become plentiful enough to raise serum levels.…”

Section: Discussionmentioning

confidence: 50%

Vitamin D Levels Affect Outcome in Pediatric Hematopoietic Stem Cell Transplantation

Hansson

Norlin

Omazic

et al. 2014

Biology of Blood and Marrow Transplantation

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The importance of vitamin D in immunologic processes has recently emerged, but whether it has any impact on the course of allogeneic hematopoietic stem cell transplantation (HSCT) has not been determined. Reports indicate that HSCT recipients, particularly children, often suffer from vitamin D deficiency. This study investigated the role of vitamin D in 123 children undergoing HSCT from 2004 to 2011. Vitamin D (ie, serum calcidiol) was analyzed in collected cryostored samples. Patients were grouped according to pre-HSCT calcidiol level: insufficient (<50 nm/L, n = 38) and sufficient (≥50 nm/L, n = 85). Older children who underwent transplants from January through June and children of Middle Eastern or African origin were more commonly found in the insufficient group. Acute grades II to IV graft-versus-host disease occurred more frequently in the vitamin D sufficient group (47% versus 30%, P = .05), whereas no difference was demonstrated for chronic graft-versus-host disease. The neutrophil granulocytes rose significantly faster in the vitamin D sufficient group. No difference in lymphocyte counts, immunoglobulin levels, or infectious disease burden during the first year post-HSCT were observed. Among children with malignancies, overall survival was significantly better in the sufficient group (87% versus 50%, P = .01). In addition, rejection (0% versus 11%, P = .06) and relapse (4% versus 33%, P = .03) rates were lower in patients with sufficient vitamin D levels. To conclude, vitamin D may have an important impact on the outcome of pediatric HSCT, particularly in patients with malignant disease. Further studies investigating whether vitamin D acts as an immunomodulator or is merely a surrogate marker of patient health or nutritional status are warranted.

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Section: Discussionmentioning

confidence: 50%

Vitamin D Levels Affect Outcome in Pediatric Hematopoietic Stem Cell Transplantation

Hansson

Norlin

Omazic

et al. 2014

Biology of Blood and Marrow Transplantation

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“…Given the good results obtained on this intensive treatment protocol, and now that our diagnostic abilities to test for prognostic translocations, DNA index and MRD have been optimized, we are considering to include a lower intensity arm that would be applicable to patients with lower risk. A study that included 26 patients of our ALL population showed that these patients had lower exercise activity, sun exposure, and bone marker levels than controls [32]. They also had higher parathyroid hormone levels, fat mass, lower bone mass at the spine, hip, and total body, as well as lower increments at these sites on follow-up.…”

Section: Discussionmentioning

confidence: 93%

Implementation of an intensive risk‐stratified treatment protocol for children and adolescents with acute lymphoblastic leukemia in Lebanon

et al. 2012

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With modern risk-adapted therapy, over 80% of children with acute lymphoblastic leukemia (ALL) in highincome countries (HICs) are cured. In countries with limited resources, however, therapy results for pediatric ALL are still not encouraging. We describe our experience in treating children with ALL using a risk-adapted protocol at a tertiary referral center in Lebanon. From May 2002 to August 2009, 111 consecutive patients 1-21 years of age with newly diagnosed ALL received the CCCL ALL protocol which was based on the St. Jude Children's Research Hospital Total XV Study. The median age at diagnosis was 5 years 5 months. The male to female ratio was 1.5. Forty-six patients received the intermediate-/high-risk arm and 65 received the low-risk arm. Only one patient (0.9%) died during induction therapy. Relapse occurred in 8 (7.2%) patients. Eight (7.2%) patients died, 4 of whom were in remission. The median follow-up of the patients was 38 months. The 5-year overall survival and event-free survival were and 88.5% (95% CI: 77.1-94.4) and 78.7% (95% CI: 69.8-88.4), respectively. Our results are comparable to those in HICs in spite of the limited resources and the relatively low socioeconomic status of the Lebanese population. Children treated on this protocol experienced significant toxicity necessitating expert supportive care, but benefited from improved cure rates and prolonged survival. Am. J. Hematol. 87:678-683, 2012. V

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“…The methods used to analyze vitamin D status were reported in all studies, however only five studies [22,30,32,36,38] reported intra assays' coefficient of variation, which ranged from 3.6 to 14% (Table 1).…”

Section: Study Selection and Study Characteristicsmentioning

confidence: 97%

Systematic review and meta-analysis: Prevalence and possible causes of vitamin D deficiency and insufficiency in pediatric cancer patients

et al. 2016

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Predictors of bone loss in childhood hematologic malignancies: a prospective study

Abstract: This study provides insight into the pathophysiology of bone loss in children receiving cancer therapy and possible interventions to optimize their skeletal health.

Cited by 16 publications

References 28 publications

Vitamin D Levels Affect Outcome in Pediatric Hematopoietic Stem Cell Transplantation

Vitamin D Levels Affect Outcome in Pediatric Hematopoietic Stem Cell Transplantation

Implementation of an intensive risk‐stratified treatment protocol for children and adolescents with acute lymphoblastic leukemia in Lebanon

Systematic review and meta-analysis: Prevalence and possible causes of vitamin D deficiency and insufficiency in pediatric cancer patients

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