R-CHOP(-like) treatment of diffuse large B-cell lymphoma significantly reduces CT-assessed vertebral bone density: a single center study of 111 patients.

Abstract

Treatment of diffuse large B-cell lymphoma (DLBCL) with R-CHOP(-like) regimens include large cumulative doses of prednisolone. In this retrospective study, we evaluated changes in vertebral bone density (VD) in DLBCL patients by measuring CT-ascertained Hounsfield units (HU) at the L3 level. In total, 111 patients diagnosed from 2007 to 2012 and response assessed following first line treatment were included. Post-treatment VD was significantly reduced to 86% of pretreatment VD on average (p < .001). Neither female sex nor high age (>70 years) were significantly associated with greater post-treatment VD reduction. Two years after completing R-CHOP treatment, VD remained significantly lower than baseline VD (p < .001). Vertebral compression fractures visualized by CT were found in 16/111 patients (14%) during follow-up. In conclusion, bone mineral density is significantly reduced following R-CHOP(-like) treatment and vertebral compression fractures are common. Glucocorticoid-induced osteoporosis may therefore have impact on survivorship for the large fraction of DLBCL patients with durable remissions.

• Authors: Pernille Svendsen, Nitesh Shekhrajka, Kasper Lindblad Nielsen, Peter Vestergaard, Mette Østergaard Poulsen, Anders Krog Vistisen, Peter Svenssen Munksgaard, Marianne Tang Severinsen, Paw Jensen, Hans Erik Johnsen, Lasse Hjort Jakobsen, Martin Bøgsted, Jens Brøndum Frøkjær, Tarec Christoffer El-Galaly
• Journal: Leukemia & lymphoma (Leuk Lymphoma) Vol. 58 Issue 5 Pg. 1105-1113 (05 2017) ISSN: 1029-2403 [Electronic] United States
• PMID: 27736260 (Publication Type: Journal Article)

Chemical References

• Antibodies, Monoclonal, Murine-Derived
• Biomarkers
• R-CHOP protocol
• Rituximab
• Vincristine
• Doxorubicin
• Cyclophosphamide
• Prednisone

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Antibodies, Monoclonal, Murine-Derived (adverse effects, therapeutic use)
• Antineoplastic Combined Chemotherapy Protocols (adverse effects, therapeutic use)
• Biomarkers
• Bone Density (drug effects)
• Combined Modality Therapy
• Cyclophosphamide (adverse effects, therapeutic use)
• Doxorubicin (adverse effects, therapeutic use)
• Female
• Humans
• Lymphoma, Large B-Cell, Diffuse (diagnosis, drug therapy, mortality)
• Male
• Middle Aged
• Odds Ratio
• Positron Emission Tomography Computed Tomography
• Prednisone (adverse effects, therapeutic use)
• Prognosis
• Rituximab
• Spine (diagnostic imaging, drug effects, pathology)
• Tomography, X-Ray Computed
• Treatment Outcome
• Vincristine (adverse effects, therapeutic use)
• Young Adult