Vitamin D status and bone health in survivors of childhood lymphoblastic leukemia

Schündeln, Michael M.; Hauffa, Pia K; Goretzki, Sara C; Lahner, Harald; Marschke, Laura; Eggert, Angelika; Hauffa, Berthold P.; Grasemann, Corinna

doi:10.1530/boneabs.2.p97

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“…This finding can be explained by the altered bone metabolism with the inability to achieve the peak bone mass during the treatment for the childhood cancer that may potentially predisposing the ALL survivors to the premature onset of osteopenia and osteoporosis; and their severe complications. [20][21][22] Hudson et al, 23 2013 reported that in 9.6% of young adult survivors the bone metabolism was disturbed and they were affected by osteoporosis. Vitamin D plays an important role in bone and mineral metabolism, and its deficiency is associated with the development of metabolic bone diseases as well as several health conditions.…”

Section: Discussionmentioning

confidence: 99%

“…Ward and colleagues, 2018 found that 36% of 186 children with ALL enrolled in their study had fractures at any skeletal site over the 6-year period. This finding can be explained by the altered bone metabolism with the inability to achieve the peak bone mass during the treatment for the childhood cancer that may potentially predisposing the ALL survivors to the premature onset of osteopenia and osteoporosis; and their severe complications 20–22 . Hudson et al, 23 2013 reported that in 9.6% of young adult survivors the bone metabolism was disturbed and they were affected by osteoporosis.…”

Section: Discussionmentioning

confidence: 99%

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OPG/RANK/RANKL Axis in Egyptian Children With Acute Lymphoblastic Leukemia After Maintenance Therapy: Relationship to Bone Mineral and Vitamin D Status

Hablas¹,

Keshk

2022

Journal of Pediatric Hematology/Oncology

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Policies to maximize peak bone mass in survivor’s children of acute lymphoblastic leukemia (ALL) have been recognized as a priority area for research. The present study aimed to evaluate the relationship between osteoprotegerin (OPG)/receptor activator of nuclear factor kappa-B (RANK)/RANK ligand (RANKL) axis, vitamin D status, and serum magnesium in ALL survivors. Sixty ALL survivors treated with chemotherapy and 60 age and sex-matched controls were included. Vitamin D and parathyroid hormone, RANK, RANKL, and OPG levels were immunoassayed, in addition to serum calcium, phosphorus, magnesium levels, and alkaline phosphatase activity assessment. Furthermore, standard anthropometric measurement, history of fractures since treatment and clinical assessment were recorded. History of bone fractures after the start of therapy was detected in 17 ALL subjects (28.33%). Significantly lower vitamin D, magnesium, calcium, and OPG levels, meanwhile, significantly higher serum parathyroid hormone, RANK, and RANKL levels were detected in survivors compared with the control group. Vitamin D level was significantly positively correlated with magnesium, calcium, and OPG levels. Meanwhile, negatively correlated with RANK and RANKL levels. ALL survivors had a high prevalence of impaired vitamin D status, decreased Mg, and altered OPG/RANK/RANKL axis with impaired bone remodeling. The results herein may open the door for new interventional actions in ALL survivors to protect against bone resorption.

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