ECE2020 Audio ePoster Presentations Bone and Calcium (121 abstracts)
Impaired bone health at cancer diagnosis in paediatric patients
Maria Nikita 1 , Artemis Doulgeraki 2 , Christina Kanaka-Gantenbein 3 , Kyriaki Karavanaki 4 , Marina Servitzogloy 1 , Helen Athanasopoulou 2 , George Polyzois 2 , Charalampos Tsentidis 5 , Margarita Baka 1 & Lydia Kossiva 4
1“P.&A. Kyriakou” Children’s Hospital, Athens, Greece, Oncology Department, Goudi, Greece; 2Institute of Child Health, Athens, Greece, Department of Bone and Mineral Metabolism, Goudi, Greece; 3“Aghia Sophia” Children’s Hospital, Athens, Greece, Division of Endocrinology, Diabetes and Metabolism, 1st Department of Paediatrics, Medical School, National and Kapodistrian University of Athens, Goudi, Greece; 4“P.&A. Kyriakou” Children’s Hospital, Athens, Greece, 2nd Department of Paediatrics, Medical School, National and Kapodistrian University of Athens, Goudi, Greece; 5Nikaea-Piraeus General Hospital “Agios Panteleimon”, Greece, Department of Endocrinology, Metabolism and Diabetes Mellitus, Goudi, Greece
Objectives: To evaluate the skeletal profile of paediatric patients with cancer at diagnosis.
Methods: Children diagnosed with cancer in our Oncology Centre were recruited during a two-year period and underwent metabolic bone profile and dual-energy X-ray absorptiometry (DXA) at the time of diagnosis.
Results: 88 children were evaluated (51 boys, 53 prepubertal), aged 7.6 ± 4.6 years. Of those, 50 were diagnosed with haematological malignancies and 37 with solid tumours. 21 out 69 patients had bone pain, (15 had a limp pain) and one sustained a femoral fracture. 43.2% (38/88) of the patients were vitamin D insufficient (25-OH-D: 12–20 ng/ml) and 5.7% (5/88) were deficient (25-OH-D <12 ng/ml). Hyperparathyroidism was present in 11.4% and hypercalciuria in 30% of all patients. One patient with hepatoblastoma had rickets. Bone turnover was also affected, particularly bone formation, because the patients had lower levels of osteocalcin (OC, P < 0.001) and procollagen type I propeptide (PICP, P = 0.001), compared to controls. Subgroup analysis revealed lower bone formation markers in the haematological subgroup i.e. OC and PICP (P = 0.001 for both markers), whereas the solid tumour subgroup had higher bone resorption markers: tartrate-resistant acid phosphatase and urine deoxypyridinoline/urine creatinine (P = 0.002 for both markers).
DXA scan was performed in 47 patients; 21,2% (10/47) of them had low-normal bone mineral density (BMD) of the lumbar spine (LS BMD Z-score between −1 and −2) and only one patient had low BMD Z-score <–2 at the same site. Two patients had low/normal BMD of total body less head scans.
Conclusion: Skeletal health is already affected at the time of diagnosis in paediatric cancer patients. Low vitamin D levels are common. Bone turnover is disturbed and follows different patterns, depending on the type of cancer. These observations support bone health surveillance and early intervention at the time of diagnosis.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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