Specific subgroups of children who survive treatment for childhood malignancies have been
shown to develop relative osteopenia following chemotherapy and are felt to be at risk for
developing osteoporosis later in life due to their inability to reach peak bone mass during
childhood. Based upon an earlier study in our department, the investigators reported
conclusive evidence that approximately half of survivors of pediatric solid malignancies are
at risk for these problems. However, the proportion of patients in our population that
showed osteopenia/osteoporosis was lower than that in other similar cross-sectional studies
in solid tumors such as osteosarcoma. The main difference between our report and the
osteosarcoma study was duration of follow-up, with ours being shorter. Longer follow-up may
prove that a larger proportion of our patients are affected. The purpose is to perform a
longitudinal follow-up study of bone mineral density using dual-energy X-ray absorptiometry
(DXA) in adult survivors of solid pediatric tumors that were previously studied as subjects
in our original cross-sectional study. The primary hypothesis is that the proportion of
pediatric solid cancer survivors with significantly lower bone mineral density (BMD)
compared to established age group controls will be increased with the additional time that
has elapsed since the original study despite the fact that the patients are young and would
not normally be expected to have osteopenia/osteoporosis at this age.
- The 38 patients from the SUNY Upstate Medical Center Pediatric Oncology Long-term
Survivor Clinic who were subjects in the original Georg Fund supported study will
comprise the patient population if they are locatable and willing to participate.
- Patients must be less than 40 years of age to participate.
- Patients who have received interval treatment for Acute Lymphocytic Leukemia (ALL)
and those who have received subsequent cranial irradiation or total body irradiation
(groups already known to be at high risk for osteoporosis) will be excluded. These
would have had to have occurred in the interval since the original study, as these
were also exclusion criteria for that study. In addition, any patient who received
interval non-autologous bone marrow transplant will be excluded, as these patients
may have graft versus host disease (also known to be associated with osteopenia).