{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T15:58:53Z","timestamp":1792425533977,"version":"4.5.0"},"reference-count":37,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2011,12,20]],"date-time":"2011-12-20T00:00:00Z","timestamp":1324339200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatric Blood &amp; Cancer"],"published-print":{"date-parts":[[2012,7,15]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>To evaluate the relationship between lumbar spine (LS) bone mineral density (BMD) and patient\u2010, disease\u2010, and therapy\u2010related variables, and to define the risk\u2010factors for fractures in children receiving therapy on Dana\u2010Farber Cancer Institute acute lymphoblastic leukemia (ALL) protocols.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Children (\u226418 years) diagnosed with ALL during the period 1995\u20132006, who are in first clinical remission, were included (n\u2009=\u2009124). Dual\u2010energy X\u2010ray absorptiometry provided LS\u2010BMD at diagnosis (n\u2009=\u200946) and during continuation therapy. LS\u2010BMD was expressed as <jats:italic>Z<\/jats:italic> scores based on local population norms. Regression analyses evaluated the risk of osteopenia (<jats:italic>Z<\/jats:italic>\u2010score \u22121.01 to \u22121.99, osteoporosis (<jats:italic>Z<\/jats:italic>\u2010score \u22122.00 or less) and fractures.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>At diagnosis, 14 0f 46 (30%) patients had osteopenia and 5 (11%) had osteoporosis; whereas, during continuation therapy, 47 of 124 (39.5%) patients had osteopenia, and 10 (8%) had osteoporosis. LS\u2010BMD at diagnosis had a positive linear relationship with LS\u2010BMD during continuation therapy (Pearson correlation coefficient 0.619, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.0001). Multivariable analyses identified age \u226510 years and LS\u2010BMD at diagnosis as independent predictors of LS\u2010BMD during continuation therapy. Twenty\u2010three (18.5%) patients developed fractures. Dexamethasone therapy (OR 3.4, 95% CI 1.31, 7.52, <jats:italic>P<\/jats:italic>\u2009=\u20090.01) and lower LS\u2010BMD during the continuation therapy (OR 1.8, 95% CI 1.2, 2.8, <jats:italic>P<\/jats:italic>\u2009=\u20090.01) were independent predictors of fracture.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Older age and lower LS\u2010BMD at diagnosis are predictors of lower LS\u2010BMD during continuation therapy. Dexamethasone and lower LS\u2010BMD during continuation therapy are associated with fractures. Using these variables it is feasible to develop a predictor model to define the risk of bony morbidity in children receiving ALL therapy. Pediatr Blood Cancer 2012; 59: 77\u201382. \u00a9 2011 Wiley Periodicals, Inc.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pbc.24040","type":"journal-article","created":{"date-parts":[[2011,12,20]],"date-time":"2011-12-20T16:40:16Z","timestamp":1324399216000},"page":"77-82","source":"Crossref","is-referenced-by-count":40,"title":["Predictors of bony morbidity in children with acute lymphoblastic leukemia"],"prefix":"10.1002","volume":"59","author":[{"given":"Meera S.","family":"Rayar","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Trishana","family":"Nayiager","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colin E.","family":"Webber","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronald D.","family":"Barr","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Uma 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