Relationships of Bone Mineral Density to Whole Body Mass, Fat Mass and Fat-free Mass in Long-term Survivors of Acute Lymphoblastic Leukemia in Childhood

• Published in: Journal of pediatric hematology/oncology Vol. 43; no. 1; p. 12
• Main Authors: Athale, Uma H, Marriott, Christopher J C, Cranston, Amy, McDonald, Paula, Webber, Colin E, Farncombe, Troy H, Barr, Ronald D
• Format: Journal Article
• Language: English
• Published: United States 01.01.2021
• Subjects: Adiposity; Adolescent; Adult; Body Composition; Body Mass Index; Bone Density; Cancer Survivors - statistics & numerical data; Cross-Sectional Studies; Female; Follow-Up Studies; Humans; Male; Precursor Cell Lymphoblastic Leukemia-Lymphoma - rehabilitation; Precursor Cell Lymphoblastic Leukemia-Lymphoma - therapy; Prognosis; Survivors - statistics & numerical data; Young Adult
• ISSN: 1536-3678
• DOI: 10.1097/MPH.0000000000001863

Body size influences bone mineral density (BMD) in health. Relationships of BMD with body mass index, fat mass (FM), fat-free mass, and appendicular lean mass were explored in acute lymphoblastic leukemia (ALL) survivors (n=75; 41 males; 45 standard risk ALL) >10 years from diagnosis. Dual energy radiograph absorptiometry performed body composition analysis. Relationships were assessed by regression analyses and Pearson correlation coefficients (r). Twenty subjects (26.3%) were osteopenic; lumbar spine (LS) BMD Z score <-1.00. Age at diagnosis, sex, ALL risk-category, type of post-induction steroid or cranial radiation did not correlate with LS or whole body (WB) BMD. Body mass index correlated significantly with LS BMD (r=0.333, P=0.004) and WB BMD (r=0.271, P=0.033). FM index (FM/height²) Z score showed no significant correlation with LS or WB BMD. Fat-free mass index Z score correlated strongly with LS BMD (r=0.386, P=0.013) and WB BMD (r=0.605, P<0.001) in males but not in females. The appendicular lean mass index, a surrogate for skeletal muscle mass, correlated significantly with LS BMD (r=0.367, P=0.018) and WB BMD (r=0.604, P<0.001) in males but not in females. Future studies to evaluate interventions to enhance BMD focused on improving body composition particularly skeletal muscle mass are warranted.