{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T19:06:52Z","timestamp":1792782412957,"version":"4.5.0"},"reference-count":29,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2014,2,28]],"date-time":"2014-02-28T00:00:00Z","timestamp":1393545600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Cancer Center Support (CORE)","award":["CA 21765"],"award-info":[{"award-number":["CA 21765"]}]},{"name":"National Cancer Institute National Institutes of Health and American Lebanese Syrian Associated Charities (ALSAC)"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatric Blood &amp; Cancer"],"published-print":{"date-parts":[[2014,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The prevalence of low bone mineral density (BMD) in adult survivors of childhood acute lymphoblastic leukemia (ALL), and the degree of recovery or decline, are not well elucidated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Procedure<\/jats:title>\n                    <jats:p>Study subjects (age\u2009\u2265\u200918 years and \u226510 years post\u2010diagnosis) participated in an institutional follow\u2010up protocol and risk\u2010based clinical evaluation based on Children's Oncology Group guidelines. Trabecular volumetric BMD was ascertained using quantitative computed tomography, reported as age\u2010 and sex\u2010specific Z\u2010scores.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>At median age 31 years, 5.7% of 845 subjects had a BMD Z\u2010score of \u2264\u22122 and 23.8% had a Z\u2010score of \u22121 to \u22122. Cranial radiation dose of \u226524\u2009Gy, but not cumulative methotrexate or prednisone equivalence doses, was associated with a twofold elevated risk of a BMD Z\u2010score of \u2264\u22121. The cranial radiation effect was stronger in females than in males. In a subset of 400 subjects, 67% of those who previously had a BMD Z\u2010score of \u2264\u22122 improved by one or more categories a median of 8.5 years later.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Very low BMD was relatively uncommon in this sample of adult survivors of childhood ALL, and BMD Z\u2010scores tended to improve from adolescence to young adulthood. High\u2010dose cranial or craniospinal radiation exposure was the primary predictor of suboptimal BMD in our study. Given that cranial radiation treatment for childhood ALL is used far more sparingly now than in earlier treatment eras, concerns about persistently low BMD among most current childhood ALL patients may be unwarranted. Pediatr Blood Cancer 2014;61:1270\u20131276. \u00a9 2014 Wiley Periodicals, Inc.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pbc.25010","type":"journal-article","created":{"date-parts":[[2014,2,28]],"date-time":"2014-02-28T20:52:31Z","timestamp":1393620751000},"page":"1270-1276","source":"Crossref","is-referenced-by-count":103,"title":["Bone mineral density among long\u2010term survivors of childhood acute lymphoblastic leukemia: Results from the St. Jude Lifetime Cohort Study"],"prefix":"10.1002","volume":"61","author":[{"given":"J. G.","family":"Gurney","sequence":"first","affiliation":[{"name":"Department of Epidemiology and Cancer Control St. Jude Children's Research Hospital Memphis Tennessee"},{"name":"School of Public Health University of Memphis Memphis Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. C.","family":"Kaste","sequence":"additional","affiliation":[{"name":"Department of Oncology St. Jude Children's Research Hospital Memphis Tennessee"},{"name":"Department of Radiological Sciences St. Jude Children's Research Hospital Memphis Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W.","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Biostatistics St. Jude Children's Research Hospital Memphis Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D. K.","family":"Srivastava","sequence":"additional","affiliation":[{"name":"Department of Biostatistics St. Jude Children's Research Hospital Memphis Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W.","family":"Chemaitilly","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Department of Pediatric Medicine St. Jude Children's Research Hospital Memphis Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K. K.","family":"Ness","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Cancer Control St. Jude Children's Research Hospital Memphis Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. Q.","family":"Lanctot","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Cancer Control St. Jude Children's Research Hospital Memphis Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. P.","family":"Ojha","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Cancer Control St. Jude Children's Research Hospital Memphis Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K. A.","family":"Nottage","sequence":"additional","affiliation":[{"name":"Department of Hematology St. Jude Children's Research Hospital Memphis Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. L.","family":"Wilson","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Cancer Control St. Jude Children's Research Hospital Memphis Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Z.","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Cancer Control St. Jude Children's Research Hospital Memphis Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L. L.","family":"Robison","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Cancer Control St. Jude Children's Research Hospital Memphis Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. M.","family":"Hudson","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Cancer Control St. Jude Children's Research Hospital Memphis Tennessee"},{"name":"Department of Oncology St. Jude Children's Research Hospital Memphis Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2014,2,28]]},"reference":[{"key":"e_1_2_5_2_1","first-page":"2","volume-title":"Principles and practice of pediatric oncology","author":"Scheurer ME","year":"2011"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2012-2393"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/00043426-199805000-00009"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPH.0b013e3181d32199"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.leu.2402078"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.20553"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.23912"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2007-1396"},{"key":"e_1_2_5_10_1","first-page":"518","volume-title":"Princples and practice of pediatric oncology","author":"Margolin JF","year":"2011"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1677\/ERC-10-0002"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2265.2003.01986.x"},{"key":"e_1_2_5_13_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2004.04.199"},{"key":"e_1_2_5_14_1","doi-asserted-by":"publisher","DOI":"10.1159\/000207611"},{"key":"e_1_2_5_15_1","doi-asserted-by":"publisher","DOI":"10.2174\/156652411794859223"},{"key":"e_1_2_5_16_1","doi-asserted-by":"publisher","DOI":"10.1530\/EJE-10-1075"},{"key":"e_1_2_5_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/jbmr.5650111122"},{"key":"e_1_2_5_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(95)70349-7"},{"key":"e_1_2_5_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/00043426-199807000-00008"},{"key":"e_1_2_5_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.24040"},{"key":"e_1_2_5_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.22875"},{"key":"e_1_2_5_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.24348"},{"key":"e_1_2_5_23_1","unstructured":"Children's Oncology Group long\u2010term follow\u2010up guidelines for survivors of childhood adolescent and young adult cancers.http:\/\/www.survivorshipguidelines.org\/pdf\/ltfuguidelines.pdf. 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