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Bone Mineral Density in Survivors of Childhood Cancer: A Meta-Analysis.

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Title: Bone Mineral Density in Survivors of Childhood Cancer: A Meta-Analysis.
Authors: Velentza, Lilly, Filis, Panagiotis, Wilhelmsson, Mari, Kogner, Per, Herold, Nikolas, Sävendahl, Lars
Source: Pediatrics. Aug2024, Vol. 154 Issue 2, p1-15. 15p.
Subjects: Risk assessment, Drug toxicity, Medical information storage & retrieval systems, Photon absorptiometry, Public health surveillance, Tumors in children, Bone density, Research funding, Femoral fractures, Hip fractures, Antineoplastic agents, Cancer patients, Meta-analysis, Descriptive statistics, Vertebral fractures, Bone fractures, Systematic reviews, MEDLINE, Medical databases, Osteoporosis, Confidence intervals, Disease risk factors, Children
Abstract: CONTEXT: There is an increasing population of childhood cancer survivors (CCS) at risk for treatment-related toxicities, including skeletal morbidities. Bone mineral density (BMD) is a proxy for bone health and reductions are associated with osteoporosis and fractures. OBJECTIVE: To investigate bone health in CCS by conducting a systematic review and meta-analysis of BMD after completed treatments. DATA SOURCES: We searched Medline, Embase, Cochrane, and Web of Science in May 2019 and updated in May 2023. STUDY SELECTION: Studies reporting BMD Z-scores measured with dual-energy x-ray absorptiometry in CCS after treatment completion. DATA EXTRACTION: We performed a pooled analysis of studies reporting BMD Z-scores and thereafter we analyzed studies comparing BMD in survivors and healthy controls. All analyses were performed based on the site of BMD measurement. RESULTS: Of 4243 studies, 84 were included (N = 8106). The mean time off-treatment across the studies ranged from 2 months to 24 years. The overall pooled mean Z-score was -0.57 (95% confidence interval [CI] -0.59 to -0.55) in the whole-body, -0.84 (95% CI -0.86 to -0.83) in the lumbar spine, -0.79 (95% CI -0.81 to -0.77) in the femoral neck and -0.14 (95% CI -0.18 to -0.11) in the total hip. When comparing survivors with controls, BMD was significantly lower in survivors at all sites. LIMITATIONS: English publications, study-level meta-analysis. CONCLUSIONS: We showed a significant reduction of BMD Z-scores in CCS. Given the increased fracture risk already within -1 SD, these results emphasize the need for BMD surveillance and secondary prevention in CCS. [ABSTRACT FROM AUTHOR]
Copyright of Pediatrics is the property of American Academy of Pediatrics and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Bone Mineral Density in Survivors of Childhood Cancer: A Meta-Analysis.
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  Data: <searchLink fieldCode="AR" term="%22Velentza%2C+Lilly%22">Velentza, Lilly</searchLink><br /><searchLink fieldCode="AR" term="%22Filis%2C+Panagiotis%22">Filis, Panagiotis</searchLink><br /><searchLink fieldCode="AR" term="%22Wilhelmsson%2C+Mari%22">Wilhelmsson, Mari</searchLink><br /><searchLink fieldCode="AR" term="%22Kogner%2C+Per%22">Kogner, Per</searchLink><br /><searchLink fieldCode="AR" term="%22Herold%2C+Nikolas%22">Herold, Nikolas</searchLink><br /><searchLink fieldCode="AR" term="%22Sävendahl%2C+Lars%22">Sävendahl, Lars</searchLink>
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  Data: <searchLink fieldCode="JN" term="%22Pediatrics%22">Pediatrics</searchLink>. Aug2024, Vol. 154 Issue 2, p1-15. 15p.
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– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: CONTEXT: There is an increasing population of childhood cancer survivors (CCS) at risk for treatment-related toxicities, including skeletal morbidities. Bone mineral density (BMD) is a proxy for bone health and reductions are associated with osteoporosis and fractures. OBJECTIVE: To investigate bone health in CCS by conducting a systematic review and meta-analysis of BMD after completed treatments. DATA SOURCES: We searched Medline, Embase, Cochrane, and Web of Science in May 2019 and updated in May 2023. STUDY SELECTION: Studies reporting BMD Z-scores measured with dual-energy x-ray absorptiometry in CCS after treatment completion. DATA EXTRACTION: We performed a pooled analysis of studies reporting BMD Z-scores and thereafter we analyzed studies comparing BMD in survivors and healthy controls. All analyses were performed based on the site of BMD measurement. RESULTS: Of 4243 studies, 84 were included (N = 8106). The mean time off-treatment across the studies ranged from 2 months to 24 years. The overall pooled mean Z-score was -0.57 (95% confidence interval [CI] -0.59 to -0.55) in the whole-body, -0.84 (95% CI -0.86 to -0.83) in the lumbar spine, -0.79 (95% CI -0.81 to -0.77) in the femoral neck and -0.14 (95% CI -0.18 to -0.11) in the total hip. When comparing survivors with controls, BMD was significantly lower in survivors at all sites. LIMITATIONS: English publications, study-level meta-analysis. CONCLUSIONS: We showed a significant reduction of BMD Z-scores in CCS. Given the increased fracture risk already within -1 SD, these results emphasize the need for BMD surveillance and secondary prevention in CCS. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
  Label:
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  Data: <i>Copyright of Pediatrics is the property of American Academy of Pediatrics and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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RecordInfo BibRecord:
  BibEntity:
    Identifiers:
      – Type: doi
        Value: 10.1542/peds.2024-066081
    Languages:
      – Code: eng
        Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 15
        StartPage: 1
    Subjects:
      – SubjectFull: Risk assessment
        Type: general
      – SubjectFull: Drug toxicity
        Type: general
      – SubjectFull: Medical information storage & retrieval systems
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      – SubjectFull: Photon absorptiometry
        Type: general
      – SubjectFull: Public health surveillance
        Type: general
      – SubjectFull: Tumors in children
        Type: general
      – SubjectFull: Bone density
        Type: general
      – SubjectFull: Research funding
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      – SubjectFull: Femoral fractures
        Type: general
      – SubjectFull: Hip fractures
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      – SubjectFull: Antineoplastic agents
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      – SubjectFull: Cancer patients
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      – SubjectFull: Meta-analysis
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      – SubjectFull: Descriptive statistics
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      – SubjectFull: Vertebral fractures
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      – SubjectFull: Bone fractures
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      – SubjectFull: Systematic reviews
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      – SubjectFull: MEDLINE
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      – SubjectFull: Medical databases
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      – SubjectFull: Osteoporosis
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      – SubjectFull: Confidence intervals
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      – SubjectFull: Disease risk factors
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      – SubjectFull: Children
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      – TitleFull: Bone Mineral Density in Survivors of Childhood Cancer: A Meta-Analysis.
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              M: 08
              Text: Aug2024
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              Y: 2024
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