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Skeletal outcome in long-term survivors of childhood high-risk neuroblastoma treated with high-dose therapy and autologous stem cell rescue
- Source :
- Bone Marrow Transplantation. 52:711-716
- Publication Year :
- 2017
- Publisher :
- Springer Science and Business Media LLC, 2017.
-
Abstract
- High-dose therapy and hematopoietic stem cell transplantation (HSCT) have been shown to improve survival rates in high-risk neuroblastoma (HR-NBL), but may cause adverse effects on the growing skeleton. We studied skeletal health in a national cohort of long-term survivors of HR-NBL (n=21; age 16-30 years, median 22 years) and in 20 healthy age- and sex-matched controls. In addition to clinical evaluation and measurement of bone mineral density (BMD) by dual-energy X-ray absorptiometry, we performed spinal magnetic resonance imaging. Skeletal complications were categorized according to Common Terminology Criteria for Adverse Events (CTCAE). Altogether, 18/21 survivors presented with at least one skeletal adverse event according to CTCAE, the most common skeletal complications being short stature (n=14) and osteopenia (n=13). Altogether, 38% of the subjects had a severe complication (CTCAE score ⩾3) including bilateral slipped capital femoral epiphyseolysis in 3/21. Fracture rate was not increased. In spinal MRI, no vertebral fractures were found and degenerative intervertebral disc changes were equally prevalent in survivors and controls. BMD was lower in survivors than controls, but differences became non-significant when adjusted for bone size. In conclusion, skeletal late complications are common and can significantly impair the quality of life in young adult survivors of HR-NBL treated with high-dose protocols and HSCT.
- Subjects :
- Adult
Male
Oncology
medicine.medical_specialty
Autologous Stem Cell Rescue
Adolescent
Antineoplastic Agents
030209 endocrinology & metabolism
Slipped Capital Femoral Epiphyses
Transplantation, Autologous
Neuroblastoma
Young Adult
03 medical and health sciences
0302 clinical medicine
Bone Density
Internal medicine
medicine
Humans
High risk neuroblastoma
Survivors
Progenitor cell
Transplantation
business.industry
Hematopoietic Stem Cell Transplantation
Hematology
medicine.disease
Magnetic Resonance Imaging
3. Good health
Surgery
Bone Diseases, Metabolic
Graft-versus-host disease
High dose therapy
Case-Control Studies
030220 oncology & carcinogenesis
Quality of Life
Female
Bone Diseases
Stem cell
business
Subjects
Details
- ISSN :
- 14765365 and 02683369
- Volume :
- 52
- Database :
- OpenAIRE
- Journal :
- Bone Marrow Transplantation
- Accession number :
- edsair.doi.dedup.....33949ee6cbfa0d52e398f0f6fba3fad1