{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,19]],"date-time":"2025-10-19T18:28:55Z","timestamp":1760898535714},"reference-count":0,"publisher":"Akademiai Kiado Zrt.","issue":"49","license":[{"start":{"date-parts":[[2020,12,6]],"date-time":"2020-12-06T00:00:00Z","timestamp":1607212800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["akjournals.com"],"crossmark-restriction":true},"short-container-title":["OH"],"published-print":{"date-parts":[[2020,12,6]]},"abstract":"<jats:p><jats:bold>\u00d6sszefoglal\u00f3.<\/jats:bold>\n                    <jats:italic>Bevezet\u00e9s:<\/jats:italic> A gyermekkori akut lymphoblastos leukaemia kezel\u00e9se\n                    napjainkban 80% feletti t\u00fal\u00e9l\u00e9st tesz lehet\u0151v\u00e9, de fontos c\u00e9l a kezel\u00e9s okozta\n                    mell\u00e9khat\u00e1sok kiv\u00e9d\u00e9se \u00e9s a gyermekek hossz\u00fa t\u00e1v\u00fa \u00e9letmin\u0151s\u00e9g\u00e9nek jav\u00edt\u00e1sa is.\n                        <jats:italic>C\u00e9lkit\u0171z\u00e9s:<\/jats:italic> A kemoter\u00e1pia csontrendszerre kifejtett\n                    mell\u00e9khat\u00e1sainak vizsg\u00e1lata \u00e9s a prognosztikai t\u00e9nyez\u0151k felt\u00e1r\u00e1sa, a\n                    rizik\u00f3faktorok \u00f6sszegy\u0171jt\u00e9se. <jats:italic>M\u00f3dszerek:<\/jats:italic> Retrospekt\u00edv\n                    vizsg\u00e1latunkba a Semmelweis Egyetem II. Gyermekgy\u00f3gy\u00e1szati Klinik\u00e1j\u00e1n 2007 \u00e9s\n                    2016 k\u00f6z\u00f6tt kezelt 215, akut lymphoblastos leukaemi\u00e1s gyermek k\u00f6z\u00fcl a\n                    csontelv\u00e1ltoz\u00e1st \u00e9szlelt betegeket vontuk be a k\u00f6vetkez\u0151, csontrendszert \u00e9rint\u0151\n                    megbeteged\u00e9sekkel: 38 gyermekn\u00e9l cs\u00f6kkent csont\u00e1sv\u00e1nyianyag-tartalom, 5 f\u0151n\u00e9l\n                    osteonecrosis, 3 f\u0151n\u00e9l osteomyelitis \u00e9s 2 f\u0151 eset\u00e9ben patol\u00f3gi\u00e1s fractura volt\n                    detekt\u00e1lhat\u00f3. K\u00fcl\u00f6nb\u00f6z\u0151 k\u00f6vet\u00e9si id\u0151pontokban gy\u0171jt\u00f6tt\u00fcnk oszteodenzitometriai\n                    adatokat, D-vitamin-, foszf\u00e1t-, alkalikusfoszfat\u00e1z- \u00e9s lipidszinteket is.\n                        <jats:italic>Eredm\u00e9nyek:<\/jats:italic> Az oszteodenzitometriai \u00e9rt\u00e9kek m\u00e1r a\n                    diagn\u00f3ziskor cs\u00f6kkent \u00e9rt\u00e9ket mutatnak, az intenz\u00edv v\u00e9n\u00e1s kemoter\u00e1pia hat\u00e1s\u00e1ra\n                    pedig tov\u00e1bbi cs\u00f6kken\u00e9s figyelhet\u0151 meg (a lumb\u00e1lis gerinc Z-score-\u00e9rt\u00e9ke a\n                    kezel\u00e9s kezdet\u00e9n: \u20131,5 \u00b1 1,02, az intenz\u00edv v\u00e9n\u00e1s kezel\u00e9s v\u00e9g\u00e9n \u20131,8 \u00b1 0,5). A\n                    Z-score-\u00e9rt\u00e9kek a fenntart\u00f3 ter\u00e1pia v\u00e9g\u00e9re javul\u00f3 tendenci\u00e1t mutattak (\u20131,6 \u00b1\n                    0,5; p&lt;0,05), majd az ut\u00e1nk\u00f6vet\u00e9s sor\u00e1n ism\u00e9telt javul\u00e1s (\u20131,2 \u00b1 0,4\n                    [p&lt;0,01] \u00e9s \u20130,9 \u00b1 0,4) figyelhet\u0151 meg. A D-vitamin-szintek eset\u00e9ben az\n                    intenz\u00edv v\u00e9n\u00e1s kemoter\u00e1pi\u00e1t k\u00f6vet\u0151en fokozatos javul\u00e1st l\u00e1thattunk (20 \u00b1 3,1\n                    ng\/ml vs. t\u00f6bb\u00e9ves ut\u00e1nk\u00f6vet\u00e9skor 31 \u00b1 2,6 ng\/ml; p&lt;0,001). A foszf\u00e1t- \u00e9s\n                    alkalikusfoszfat\u00e1z-szintek nem v\u00e1ltoztak sz\u00e1mottev\u0151 m\u00e9rt\u00e9kben a vizsg\u00e1lt\n                    id\u0151tartam sor\u00e1n. A koleszterinszintek a ter\u00e1pia sor\u00e1n folyamatos n\u00f6veked\u00e9st\n                    mutattak (a kemoter\u00e1pia kezdet\u00e9n 3,28 \u00b1 0,3 mM\/l vs. a fenntart\u00f3 kezel\u00e9s v\u00e9g\u00e9n\n                    4,62 \u00b1 0,2 mM\/l; p&lt;0,0001). A HDL-koleszterin eset\u00e9ben szint\u00e9n hasonl\u00f3\n                    tendenci\u00e1t figyelhett\u00fcnk meg (a diagn\u00f3ziskor 0,53 \u00b1 0,09 mM\/l vs. a fenntart\u00f3\n                    kezel\u00e9s v\u00e9g\u00e9n 1,48 \u00b1 0,14 mM\/l). <jats:italic>K\u00f6vetkeztet\u00e9s:<\/jats:italic> Kiemelend\u0151,\n                    hogy a gy\u00f3gyult gyermekek ut\u00e1nk\u00f6vet\u00e9se, az oszteodenzitometriai m\u00e9r\u00e9sek \u00e9s a\n                    laborparam\u00e9terek ellen\u0151rz\u00e9se rendk\u00edv\u00fcl fontos, mivel csontelv\u00e1ltoz\u00e1sokkal a\n                    leukaemi\u00e1s betegek eset\u00e9n sz\u00e1molni kell. Orv Hetil. 2020; 161(49):\n                    2086\u20132093.<\/jats:p>\n                <jats:p><jats:bold>Summary.<\/jats:bold>\n                    <jats:italic>Introduction:<\/jats:italic> Current treatment of pediatric acute\n                    lymphoblastic leukemia allows survival above 80%, but it is also very important\n                    to prevent treatment-related side effects and to improve long-term quality of\n                    life. <jats:italic>Objective:<\/jats:italic> Our aim was to assess the side effects of\n                    chemotherapy on the skeletal system and to identify prognostic and risk factors.\n                        <jats:italic>Methods:<\/jats:italic> Between 2007 and 2016, 215 children were treated\n                    with acute lymphoblastic leukemia at the 2nd Department of Paediatrics,\n                    Semmelweis University. In our retrospective study, we analyzed data of these\n                    children with skeletal-related side-effects (38 children with reduced bone\n                    mineral density, 5 with osteonecrosis, 3 with osteomyelitis and 2 with\n                    pathologic fracture). <jats:italic>Results:<\/jats:italic> Osteodensitometric data, vitamin\n                    D, phosphate, alkaline phosphatase and lipid levels were collected at different\n                    follow-up times. Osteodensitometric values were already reduced at the time of\n                    diagnosis (lumbar spine Z-score: \u20131.5 \u00b1 1.02) and intensive venous chemotherapy\n                    caused further decrease (\u20131.8 \u00b1 0.5). Z-score showed an improving tendency at\n                    the end of the maintenance therapy (\u20131.6 \u00b1 0.5; p&lt;0.05), followed by further\n                    improvement later (\u20131.2 \u00b1 0.4 [p&lt;0.01] and \u20130.9 \u00b1 0.4). Vitamin D levels\n                    showed improvement after intensive venous chemotherapy (20 \u00b1 3.1 ng\/ml vs. 31 \u00b1\n                    2.6 ng\/ml at multi-year follow-up; p&lt;001). Phosphate and alkaline phosphatase\n                    levels did not change considerably during the period considered. Cholesterol\n                    levels increased continuously during treatment (at the time of diagnosis 3.28 \u00b1\n                    0.3 mM\/l vs. at the end of the maintenance therapy 4.62 \u00b1 0.2 mM\/l;\n                    p&lt;0.0001). A similar trend was observed with HDL cholesterol levels (0.53 \u00b1\n                    0.09 mM\/l vs. 1.48 \u00b1 0.14 mM\/l). <jats:italic>Conclusion:<\/jats:italic> In summary, we can\n                    conclude that follow-up of these children, osteodensitometric measurements and\n                    monitoring of laboratory parameters are extremely important, as bone\n                    abnormalities can occur in leukemia patients. Orv Hetil. 2020; 161(49):\n                    2086\u20132093.<\/jats:p>","DOI":"10.1556\/650.2020.31940","type":"journal-article","created":{"date-parts":[[2020,12,9]],"date-time":"2020-12-09T02:28:33Z","timestamp":1607480913000},"page":"2086-2093","update-policy":"http:\/\/dx.doi.org\/10.1556\/policypage.crossmark.crossref.1","source":"Crossref","is-referenced-by-count":2,"title":["Az akut lymphoblastos leukaemi\u00e1val kezelt gyermekek csontrendszer\u00e9t \u00e9rint\u0151 mell\u00e9khat\u00e1sok"],"prefix":"10.1556","volume":"161","author":[{"given":"Nikolett Jusztina","family":"Beniczky","sequence":"first","affiliation":[{"name":"1 \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar, II. Gyermekgy\u00f3gy\u00e1szati Klinika, Semmelweis Egyetem, Budapest, T\u0171zolt\u00f3 u. 7\u20139., 1094"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"\u00c9va","family":"Hossz\u00fa","sequence":"additional","affiliation":[{"name":"1 \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar, II. Gyermekgy\u00f3gy\u00e1szati Klinika, Semmelweis Egyetem, Budapest, T\u0171zolt\u00f3 u. 7\u20139., 1094"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D\u00e1niel J\u00e1nos","family":"Erd\u00e9lyi","sequence":"additional","affiliation":[{"name":"1 \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar, II. Gyermekgy\u00f3gy\u00e1szati Klinika, Semmelweis Egyetem, Budapest, T\u0171zolt\u00f3 u. 7\u20139., 1094"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Judit","family":"M\u00fcller","sequence":"additional","affiliation":[{"name":"1 \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar, II. Gyermekgy\u00f3gy\u00e1szati Klinika, Semmelweis Egyetem, Budapest, T\u0171zolt\u00f3 u. 7\u20139., 1094"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zsuzsanna","family":"Jakab","sequence":"additional","affiliation":[{"name":"2 Orsz\u00e1gos Gyermektumor Regiszter, Budapest"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G\u00e1bor","family":"Kov\u00e1cs","sequence":"additional","affiliation":[{"name":"1 \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar, II. Gyermekgy\u00f3gy\u00e1szati Klinika, Semmelweis Egyetem, Budapest, T\u0171zolt\u00f3 u. 7\u20139., 1094"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"425","container-title":["Orvosi Hetilap"],"original-title":[],"link":[{"URL":"https:\/\/akjournals.com\/view\/journals\/650\/161\/49\/article-p2086.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/akjournals.com\/downloadpdf\/journals\/650\/161\/49\/article-p2086.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,10,11]],"date-time":"2021-10-11T01:14:01Z","timestamp":1633914841000},"score":1,"resource":{"primary":{"URL":"https:\/\/akjournals.com\/view\/journals\/650\/161\/49\/article-p2086.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,12,6]]},"references-count":0,"journal-issue":{"issue":"49"},"URL":"https:\/\/doi.org\/10.1556\/650.2020.31940","relation":{},"ISSN":["0030-6002","1788-6120"],"issn-type":[{"value":"0030-6002","type":"print"},{"value":"1788-6120","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,12,6]]}}}