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

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

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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.

OriginalsprogEngelsk
TidsskriftLeukemia and Lymphoma
Vol/bind58
Udgave nummer5
Sider (fra-til)1105-1113
Antal sider9
ISSN1042-8194
DOI
StatusUdgivet - 2017

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