诊断时的骨矿物质状况 在患有血液恶性瘤的儿童中
Maria Nikita1, Artemis Doulgeraki2, Margarita Baka1
1Department of Oncology, « P.&A. Kyriakou » Children's Hospital, Athens, Greece.
Pediatric hematology and oncology
|April 18, 2025
概括
患有急性淋巴细胞白血病 (ALL) 和淋巴瘤的儿童癌症患者在诊断时显示骨矿物质密度 (BMD) 降低. 早期的骨健康监测和干预对这些年轻患者至关重要.
科学领域:
- 儿科瘤学 儿科瘤学
- 儿科内分泌学 儿科内分泌学
- 骨健康 骨健康
背景情况:
- 骨矿物质密度降低 (BMD) 是儿童血液恶性瘤治疗期间和之后的一个已知的并发症.
- 在诊断时,这些儿科患者的骨状况仍未得到充分研究.
- 血液恶性瘤如急性淋巴细胞白血病 (ALL),霍奇金淋巴瘤 (HL) 和非霍奇金淋巴瘤 (NHL) 可以影响整体健康,包括骨健康.
研究的目的:
- 评估新诊断的儿科患者的骨形状,包括ALL,HL和NHL.
- 在诊断时评估这些患者的骨代谢和骨硬化.
- 为了比较患者的骨状况与年龄和性别匹配的对照.
主要方法:
- 一项病例控制研究涉及71名儿科患者 (50名ALL,11名HL,10名NHL) 和108名对照患者.
- 骨代谢评估,包括血清标志物 (PICP,OC,bTRAP5b) 和维生素D水平 (25-OH-D).
- 双能X射线吸收仪 (DXA) 扫描以测量腰椎 (LS) 和全身不含头部 (TBLH) 的 BMD Z-score.
主要成果:
- 与对照组相比,患者的PICP,OC和bTRAP5b血清水平较低 (p < 0.001).
- 患有ALL和淋巴瘤的患者的LS BMDZ分数显著降低 (分别p < 0.001,p < 0.01).
- 与对照组相比,小儿ALL患者的TBLH BMD Z-score较低 (p = 0.003).与对照组相比,这些患者的TBLH BMD Z-score较低 (p = 0.003).
结论:
- 在诊断时患有ALL和淋巴瘤的儿科患者中,骨健康受到不利影响.
- 这些发现凸显了从诊断到儿科癌症患者骨健康监测的必要性.
- 应考虑及时采取干预策略,从诊断开始解决骨健康问题.
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