{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T15:22:36Z","timestamp":1784215356485,"version":"3.55.0"},"reference-count":77,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2022,3,10]],"date-time":"2022-03-10T00:00:00Z","timestamp":1646870400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background: Overall survival after lymphoma has improved in recent years, but the high prevalence of late treatment-related sequelae has been observed as a counterpart. Method: In this systematic review, FIL researchers aimed to: (i) estimate the incidence or prevalence of late endocrine-metabolic sequelae, (ii) evaluate the effects of modern therapeutic approaches on incidence or prevalence of late endocrine-metabolic sequelae, and (iii) determine whether there is evidence of follow-up schemes for their screening\/early diagnosis in the subset of long-term classical Hodgkin lymphoma (cHL) and diffuse large B-cell lymphoma (DLBCL) survivors treated at adult age. The MEDLINE, Embase and the Cochrane Library databases were searched for relevant articles published up to October, 2020. The study selection process was conducted by three independent reviewers and was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A risk of bias assessment was performed using the Cochrane tool for randomized trials and the Newcastle-Ottawa Scale for observational studies. Results: In the final analysis, eight studies were included, four of which focused on thyroid disease, two on gonadal dysfunction, one on bone disease and one on metabolic syndrome. Hypothyroidism was reported in up to 60% of adult cHL survivors and was frequently recorded even with modern radiotherapy approaches. Menopause occurred in 52\u201372% of women after chemotherapy. An 86% reduction in vertebral density was reported following R-CHOP-like chemotherapy. Sarcopenia and metabolic syndrome were reported in 37.9% and 60% of patients, respectively. No validated screening protocols were found for the early diagnosis of long-term treatment-related endocrine and metabolic sequelae, thus the authors finally suggest the execution of screening exams according to the risk category which were identified in the epidemiologic studies.<\/jats:p>","DOI":"10.3390\/cancers14061439","type":"journal-article","created":{"date-parts":[[2022,3,10]],"date-time":"2022-03-10T20:19:10Z","timestamp":1646943550000},"page":"1439","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Late Endocrine and Metabolic Sequelae and Long-Term Monitoring of Classical Hodgkin Lymphoma and Diffuse Large B-Cell Lymphoma Survivors: A Systematic Review by the Fondazione Italiana Linfomi"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3454-7330","authenticated-orcid":false,"given":"Sergio","family":"Di Molfetta","sequence":"first","affiliation":[{"name":"Department of Emergency and Organ Transplantation, Section of Internal Medicine, Endocrinology, Andrology and Metabolic Diseases, University of Bari Aldo Moro, 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonella","family":"Daniele","sequence":"additional","affiliation":[{"name":"Experimental Oncology and Biobank Management Unit, RCCS Istituto Tumori \u201cGiovanni Paolo II\u201d, 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Gerardi","sequence":"additional","affiliation":[{"name":"Istituto di Ricerche Farmacologiche \u201cMario Negri\u201d IRCCS, 20156 Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eleonora","family":"Allocati","sequence":"additional","affiliation":[{"name":"Istituto di Ricerche Farmacologiche \u201cMario Negri\u201d IRCCS, 20156 Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5707-0689","authenticated-orcid":false,"given":"Carla","family":"Minoia","sequence":"additional","affiliation":[{"name":"Hematology Unit, IRCCS Istituto Tumori \u201cGiovanni Paolo II\u201d, 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giacomo","family":"Loseto","sequence":"additional","affiliation":[{"name":"Hematology Unit, IRCCS Istituto Tumori \u201cGiovanni Paolo II\u201d, 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7372-2678","authenticated-orcid":false,"given":"Francesco","family":"Giorgino","sequence":"additional","affiliation":[{"name":"Department of Emergency and Organ Transplantation, Section of Internal Medicine, Endocrinology, Andrology and Metabolic Diseases, University of Bari Aldo Moro, 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Attilio","family":"Guarini","sequence":"additional","affiliation":[{"name":"Hematology Unit, IRCCS Istituto Tumori \u201cGiovanni Paolo II\u201d, 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vitaliana","family":"De Sanctis","sequence":"additional","affiliation":[{"name":"Department of Medicine, Surgery and Translational Medicine, \u201cSapienza\u201d University of Rome, Radiotherapy Oncology, St. Andrea Hospital, Via di Grottarossa 1035, 00189 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,3,10]]},"reference":[{"key":"ref_1","unstructured":"(2020, March 15). National Comprehensive Cancer Network Guidelines version 2.2020 \u201cSurvivorship\u201d. Available online: https:\/\/www.nccn.org\/professionals\/physician_gls\/pdf\/survivorship.pdf."},{"key":"ref_2","unstructured":"(2021, January 15). Haematological Malignancy Research Network (HMRN). Available online: https:\/\/www.hmrn.org\/statistics\/survival."},{"key":"ref_3","unstructured":"(2021, June 05). National Comprehensive Cancer Networ Guidelines version 4.2021 \u201cHodgkin Lymphoma\u201d. Available online: https:\/\/www.nccn.org\/professionals\/physician_gls\/pdf\/hodgkins.pdf."},{"key":"ref_4","unstructured":"(2021, June 05). National Cancer Institute: Surveillance, Epidemiology, and End Results Program, Available online: https:\/\/seer.cancer.gov\/statfacts\/html\/dlbcl.html."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"v116","DOI":"10.1093\/annonc\/mdv304","article-title":"ESMO Guidelines Committee. Diffuse large B-Cell Lymphoma (DLBCL): ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up","volume":"26","author":"Tilly","year":"2015","journal-title":"Ann. Oncol."},{"key":"ref_6","unstructured":"(2021, June 05). National Comprehensive Cancer Networ Guidelines version 4.2021 \u201cB-cell lymphomas\u201d. Available online: https:\/\/www.nccn.org\/professionals\/physician_gls\/pdf\/b-cell.pdf."},{"key":"ref_7","unstructured":"(2021, June 05). AIRTUM 2020: I Numeri del Cancro in Italia. Available online: www.registri-tumori.it."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"604","DOI":"10.1002\/ajh.25460","article-title":"Diffuse large B cell lymphoma: 2019 update on diagnosis, risk stratification and treatment","volume":"94","author":"Liu","year":"2019","journal-title":"Am. J. Hematol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1177\/0300891620905649","article-title":"Management of lymphoma survivor patients in Italy: An evaluation by Fondazione Italiana Linfomi","volume":"107","author":"Minoia","year":"2021","journal-title":"Tumori J."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1016\/j.clml.2017.08.097","article-title":"Improving Provision of Care for Long-term Survivors of Lymphoma","volume":"17","author":"Ciavarella","year":"2017","journal-title":"Clin. Lymphoma Myeloma Leuk."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1053\/j.seminhematol.2016.05.008","article-title":"Hodgkin Lymphoma: Late Effects of Treatment and Guidelines for Surveillance","volume":"53","author":"Ng","year":"2016","journal-title":"Semin. Hematol."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Gerardi, C., Allocati, E., Minoia, C., Guarini, A., and Banzi, R. (2021). Long-Term Follow-Up of Classical Hodgkin Lymphoma and Diffuse Large B-Cell Lymphoma Survivors: Aims and Methodological Approach for Fondazione Italiana Linfomi Systematic Reviews. Cancers, 13.","DOI":"10.3390\/cancers13122976"},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Minoia, C., Gerardi, C., Allocati, E., Daniele, A., De Sanctis, V., Bari, A., and Guarini, A. (2021). The Impact of Healthy Lifestyles on Late Sequelae in Classical Hodgkin Lymphoma and Diffuse Large B-Cell Lymphoma Survivors. A Systematic Review by the Fondazione Italiana Linfomi. Cancers, 13.","DOI":"10.3390\/cancers13133135"},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Franceschetti, S., Annunziata, M.A., Agostinelli, G., Gerardi, C., Allocati, E., Minoia, C., and Guarini, A. (2021). Late Neurological and Cognitive Sequelae and Long-Term Monitoring of Classical Hodgkin Lymphoma and Diffuse Large B-Cell Lymphoma Survivors: A Systematic Review by the Fondazione Italiana Linfomi. Cancers, 13.","DOI":"10.3390\/cancers13143401"},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Viviani, S., Caccavari, V., Gerardi, C., Allocati, E., Minoia, C., and Di Russo, A. (2021). Male and female fertility: Prevention and monitoring in classical Hodgkin lymphoma and diffuse large B cell Lymphoma survivors. A systematic review by the Fondazione ItalianaLinfomi. Cancers, 13.","DOI":"10.3390\/cancers13122881"},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Daniele, A., Guarini, A., Summa, S., Dellino, M., Lerario, G., Ciavarella, S., Ditonno, P., Paradiso, A.V., Divella, R., and Casamassima, P. (2021). Body Composition Change, Unhealthy Lifestyles and Steroid Treatment as Predictor of Metabolic Risk in Non-Hodgkin\u2019s Lymphoma Survivors. J. Pers. Med., 11.","DOI":"10.3390\/jpm11030215"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1093\/annonc\/3.suppl_4.S105","article-title":"Long-term gonadal dysfunction and its impact on bone mineralization in patients following COPP\/ABVD chemotherapy for Hodgkin\u2019s disease","volume":"3","author":"Kreuser","year":"1992","journal-title":"Ann. Oncol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"49","DOI":"10.3109\/0284186X.2014.948057","article-title":"Fatigue in male lymphoma survivors differs between diagnostic groups and is associated with latent hypothyroidism","volume":"54","author":"Kiserud","year":"2015","journal-title":"Acta Oncol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1530\/EJE-15-0174","article-title":"Self-reported endocrine late effects in adults treated for brain tumours, Hodgkin and non-Hodgkin lymphoma: A registry based study in Northern Germany","volume":"173","author":"Gebauer","year":"2015","journal-title":"Eur. J. Endocrinol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"854","DOI":"10.1016\/j.ijrobp.2013.05.005","article-title":"Modern Radiation Therapy for Hodgkin Lymphoma: Field and Dose Guidelines From theInternational Lymphoma Radiation Oncology Group (ILROG)","volume":"89","author":"Specht","year":"2014","journal-title":"Int. J. Radiat. Oncol. Biol. Phys."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1016\/j.ijrobp.2015.01.009","article-title":"Modern Radiation Therapy for Extranodal Lymphomas: Field and Dose Guidelines from the International Lymphoma Radiation Oncology Group","volume":"92","author":"Yahalom","year":"2015","journal-title":"Int. J. Radiat. Oncol. Biol. Phys."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1000097","DOI":"10.1371\/journal.pmed.1000097","article-title":"Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement","volume":"6","author":"Moher","year":"2009","journal-title":"PLoS Med."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"j4008","DOI":"10.1136\/bmj.j4008","article-title":"AMSTAR 2: A critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both","volume":"358","author":"Shea","year":"2017","journal-title":"BMJ"},{"key":"ref_24","unstructured":"Higgins, J.P., and Green, S. (2010). The Cochrane Collaboration\u2019s tool for assessing risk of bias. Cochrane Handbook for Systematic Reviews of Interventions, John Wiley and Sons."},{"key":"ref_25","unstructured":"Wells, G.S.B., O\u2019connell, D., Peterson, J., Welch, V., Losos, M., and Tugwell, P. (1999). The Newcastle-Ottawa Scale (NOS) for Assessing the Quality of Non-randomised Studies in Meta-Analyses, Ottawa Health Research Institute. Available online: http:\/\/www.ohri.ca\/programs\/clinical_epidemiology\/oxford.asp."},{"key":"ref_26","first-page":"917","article-title":"Relapse and late complications in early-stage Hodgkin\u2019s disease patients with mediastinal involvement treated with radiotherapy alone or plus one cycle of ABVD","volume":"84","author":"MauriziEnrici","year":"1999","journal-title":"Haematologica"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1007\/s002770050565","article-title":"Thyroid toxicity of treatment for Hodgkin\u2019s disease","volume":"79","author":"Bethge","year":"2000","journal-title":"Ann. Hematol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1159\/000067269","article-title":"Hypothyroidism and thyroiditis after therapy for Hodgkin\u2019s disease","volume":"109","author":"Keresztes","year":"2003","journal-title":"Acta Haematol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"530","DOI":"10.1016\/j.ijrobp.2018.03.003","article-title":"Predictors of Hypothyroidism in Hodgkin Lymphoma Survivors After Intensity Modulated Versus 3-Dimensional Radiation Therapy","volume":"101","author":"Pinnix","year":"2018","journal-title":"Int. J. Radiat. Oncol. Biol. Phys."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1247","DOI":"10.1136\/jcp.38.11.1247","article-title":"Fertility in young men and women after treatment for lymphoma: A study of a population","volume":"38","author":"King","year":"1985","journal-title":"J. Clin. Pathol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1771","DOI":"10.1093\/annonc\/mdv227","article-title":"Long-term ovarian function in women treated with CHOP or CHOP plus etoposide for aggressive lymphoma","volume":"26","author":"Meissner","year":"2015","journal-title":"Ann. Oncol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1105","DOI":"10.1080\/10428194.2016.1233543","article-title":"R-CHOP(-like) treatment of diffuse large B-cell lymphoma significantly reduces CT-assessed vertebral bone density: A single center study of 111 patients","volume":"58","author":"Svendsen","year":"2017","journal-title":"Leuk. Lymphoma"},{"key":"ref_33","first-page":"3227","article-title":"Abnormalities of the thyroid in survivors of Hodgkin\u2019s disease: Data from the Childhood Cancer Survivor Study","volume":"85","author":"Sklar","year":"2000","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1634\/theoncologist.1-1-62","article-title":"Thyroid abnormalities after therapy for Hodgkin\u2019s disease in childhood","volume":"1","author":"Bhatia","year":"1996","journal-title":"Oncologist"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1153","DOI":"10.1016\/j.bbmt.2007.06.003","article-title":"Late Effects in Survivors of Hodgkin and Non-Hodgkin Lymphoma Treated with Autologous Hematopoietic Cell Transplantation: A Report from the Bone Marrow Transplant Survivor Study","volume":"13","author":"Majhail","year":"2007","journal-title":"Biol. Blood Marrow Transplant."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1182\/asheducation-2016.1.323","article-title":"Long-term risk of second malignancy and cardiovascular disease after Hodgkin lymphoma treatment","volume":"2016","author":"Flora","year":"2016","journal-title":"Hematology"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"636","DOI":"10.1016\/j.ijrobp.2013.11.237","article-title":"Thyroid Malignancies in Survivors of Hodgkin Lymphoma","volume":"88","author":"Michaelson","year":"2014","journal-title":"Int. J. Radiat. Oncol. Biol. Phys."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1180","DOI":"10.1080\/10428194.2017.1369063","article-title":"A population-based study of prognosis and survival in patients with second primary thyroid cancer after Hodgkin lymphoma","volume":"59","author":"Chowdhry","year":"2017","journal-title":"Leuk. Lymphoma"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"2400","DOI":"10.1002\/ijc.24581","article-title":"Risk of thyroid cancer in survivors of childhood cancer Results from the British Childhood Cancer Survivor Study","volume":"125","author":"Taylor","year":"2009","journal-title":"Int. J. Cancer"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1007\/s11764-016-0588-6","article-title":"Screening for Thyroid Cancer in Survivors of Childhood and Young Adult Cancer Treated with Neck Radiation","volume":"11","author":"Tonorezos","year":"2017","journal-title":"J. Cancer Surviv."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"716","DOI":"10.1089\/thy.2014.0460","article-title":"Management Guidelines for Children with Thyroid Nodules and Differentiated Thyroid Cancer","volume":"25","author":"Francis","year":"2015","journal-title":"Thyroid. Off. J. Am. Thyroid. Assoc."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1","DOI":"10.4158\/EP161208.GL","article-title":"American Association of Clinical Endocrinologists, American College of Endocrinology, and Associazione Medici Endocrinologi Medical Guidelines for Clinical Practice for the Diagnosis and Management of Thyroid Nodules\u20142016 Update Appendix","volume":"22","author":"Gharib","year":"2016","journal-title":"Endocr. Pract."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"622","DOI":"10.4158\/EP161208.GL","article-title":"Aace\/ace\/ame task force on thyroid nodules. American association of clinical endocrinologists, American college of endocrinology, and associazione medici endocrinologi medical guidelines for clinical practice for the diagnosis and management of thyroid nodules\u20142016 update","volume":"22","author":"Gharib","year":"2016","journal-title":"Endocr. Pract."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1001\/jama.291.2.228","article-title":"Subclinical thyroid disease: Scientific review and guidelines for diagnosis and management","volume":"291","author":"Surks","year":"2004","journal-title":"JAMA"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"988","DOI":"10.4158\/EP12280.GL","article-title":"Clinical practice guidelines for hypothyroidism in adults: Cosponsored by the American Association of Clinical Endocrinologists and the American Thyroid Association","volume":"18","author":"Garber","year":"2012","journal-title":"Endocr. Pract."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"102981","DOI":"10.1016\/j.critrevonc.2020.102981","article-title":"Novel aspects on gonadotoxicity and fertility preservation in lymphoproliferative neoplasms","volume":"151","author":"Silvestris","year":"2020","journal-title":"Crit. Rev. Oncol. Hematol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1093\/humrep\/deg016","article-title":"The radiosensitivity of the human oocyte","volume":"8","author":"Wallace","year":"2003","journal-title":"Hum. Reprod."},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Qu, N., Itoh, M., and Sakabe, K. (2019). Effects of Chemotherapy and Radiotherapy on Spermatogenesis: The Role of Testicular Immunology. Int. J. Mol. Sci., 20.","DOI":"10.3390\/ijms20040957"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1007\/978-3-642-69132-4_16","article-title":"Gonadal damage in Hodgkin\u2019s disease from cancer chemotherapeutic regimens","volume":"7","author":"Bonadonna","year":"1984","journal-title":"Arch. Toxicol."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1428","DOI":"10.1093\/annonc\/mdl149","article-title":"Treatment-related premature ovarian failure as a long-term complication after Hodgkin\u2019s lymphoma","volume":"17","author":"Haukvik","year":"2006","journal-title":"Ann. Oncol."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1200\/JCO.2012.44.3721","article-title":"Gonadal Function and Fertility in Survivors After Hodgkin Lymphoma Treatment Within the German Hodgkin Study Group HD13 to HD15 Trials","volume":"31","author":"Behringer","year":"2013","journal-title":"J. Clin. Oncol."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1007\/BF01727413","article-title":"Long-term gonadal toxicity after therapy for Hodgkin\u2019s and non-Hodgkin\u2019s lymphoma","volume":"68","author":"Bokemeyer","year":"1994","journal-title":"Ann. Hematol."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1038\/sj.bjc.6604892","article-title":"Gonadal function in male patients after treatment for malignant lymphomas, with emphasis on chemotherapy","volume":"100","author":"Kiserud","year":"2009","journal-title":"Br. J. Cancer"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"2241","DOI":"10.1007\/s00464-010-1541-9","article-title":"Needle oophoropexy: A new simple technique for ovarian transposition prior to pelvic irradiation","volume":"25","author":"Gareer","year":"2011","journal-title":"Surg. Endosc."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"2169","DOI":"10.1200\/JCO.2017.76.3441","article-title":"Reproductive Function and Outcomes in Female Survivors of Childhood, Adolescent, and Young Adult Cancer: A Review","volume":"36","author":"Haupt","year":"2018","journal-title":"J. Clin. Oncol."},{"key":"ref_56","doi-asserted-by":"crossref","unstructured":"Michalczyk, K., and Cymbaluk-P\u0142oska, A. (2021). Fertility Preservation and Long-Term Monitoring of Gonadotoxicity in Girls, Adolescents and Young Adults Undergoing Cancer Treatment. Cancers, 13.","DOI":"10.3390\/cancers13020202"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"1514","DOI":"10.1080\/10428190701471973","article-title":"Elderly patients with non-Hodgkin lymphoma who receive chemotherapy are at higher risk for osteoporosis and fractures","volume":"48","author":"Cabanillas","year":"2007","journal-title":"Leuk. Lymphoma."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1038\/bjc.1994.308","article-title":"Reduced bone mineral density in men following chemotherapy for Hodgkin\u2019s disease","volume":"70","author":"Holmes","year":"1994","journal-title":"Br. J. Cancer"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"481","DOI":"10.1093\/annonc\/mdt560","article-title":"Alterations in bone mineral density and bone turnover markers in newly diagnosed adults with lymphoma receiving chemotherapy: A 1-year prospective pilot study","volume":"25","author":"Paccou","year":"2014","journal-title":"Ann. Oncol."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"1521","DOI":"10.1002\/art.40137","article-title":"American College of Rheumatology Guideline for the prevention and treatment of glucocorticoid-induced osteoporosis","volume":"69","author":"Buckley","year":"2017","journal-title":"Arthritis Rheumatol."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"430","DOI":"10.1016\/j.radonc.2016.03.002","article-title":"Bone mineral density loss in thoracic and lumbar vertebrae following radiation for abdominal cancers","volume":"118","author":"Wei","year":"2016","journal-title":"Radiother. Oncol."},{"key":"ref_62","unstructured":"US. Preventive Services Task Force (2018). Screening for Osteoporosis to Prevent Fractures: Recommendation Statement. Am. Fam. Physician., 98, 102\u2013108."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1002\/hon.2900100308","article-title":"Bone mineral density (BMD) in patients with lymphoma: The effect of chemotherapy, intermittent corticosteroids and premature menopause","volume":"10","author":"Ratcliffe","year":"1992","journal-title":"Hematol. Oncol."},{"key":"ref_64","doi-asserted-by":"crossref","unstructured":"American Medical Association (2001). Expert Panel on Detection, Evaluation Treatment of High Blood Cholesterol in Adults\u2014Executive Summary of The Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III). JAMA, 285, 2486\u20132497.","DOI":"10.1001\/jama.285.19.2486"},{"key":"ref_65","first-page":"1509","article-title":"Cancer survival rates continue to rise in the Netherlands","volume":"322","author":"Sheldon","year":"2001","journal-title":"BMJ"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"2404","DOI":"10.1210\/jc.2003-030242","article-title":"The emergence of the metabolic syndrome with menopause","volume":"88","author":"Carr","year":"2003","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"1036","DOI":"10.2337\/diacare.27.5.1036","article-title":"Testosterone and sex hormone-binding globulin predict the metabolic syndrome and diabetes in middle-aged men","volume":"27","author":"Laaksonen","year":"2004","journal-title":"Diabetes Care"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"563","DOI":"10.1016\/S0002-9343(01)00663-5","article-title":"Hypogonadism and androgen replacement therapy in elderly men","volume":"110","author":"Basaria","year":"2001","journal-title":"Am. J. Med."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"1381","DOI":"10.1001\/archinternmed.2009.209","article-title":"Diabetes mellitus in long-term survivors of childhood cancer. Increased risk associated with radiation therapy: A report for the childhood cancer survivor study","volume":"169","author":"Meacham","year":"2009","journal-title":"Arch. Intern. Med."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"1002","DOI":"10.1016\/S1470-2045(12)70323-6","article-title":"Radiation dose to the pancreas and risk of diabetes mellitus in childhood cancer survivors: A retrospective cohort study","volume":"13","author":"Haddy","year":"2012","journal-title":"Lancet Oncol."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"3257","DOI":"10.1200\/JCO.2013.54.4379","article-title":"Risk of Diabetes Mellitus in Long-Term Survivors of Hodgkin Lymphoma","volume":"32","author":"Schaapveld","year":"2014","journal-title":"J. Clin. Oncol."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"545","DOI":"10.1016\/S2213-8587(15)00038-8","article-title":"Screening and management of adverse endocrine outcomes in adult survivors of childhood and adolescent cancer Emily S Tonorezos","volume":"3","author":"Tonorezos","year":"2015","journal-title":"Lancet Diabetes Endocrinol."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"21S","DOI":"10.1177\/0148607111413773","article-title":"Body composition (sarcopenia) in obese patients: Implications for care in the intensive care unit","volume":"35","author":"Gallagher","year":"2011","journal-title":"J. Parenter. Enter. Nutr."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"R67","DOI":"10.1530\/JOE-15-0533","article-title":"Insulin resistance and sarcopenia: Mechanistic links between common co-morbidities","volume":"229","author":"Cleasby","year":"2016","journal-title":"J. Endocrinol."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"513","DOI":"10.1038\/s41574-018-0062-9","article-title":"Sarcopenic obesity in older adults: Aetiology, epidemiology and treatment strategies","volume":"14","author":"Batsis","year":"2018","journal-title":"Nat. Rev. Endocrinol."},{"key":"ref_76","doi-asserted-by":"crossref","unstructured":"Fischetti, F., Greco, G., Cataldi, S., Minoia, C., Loseto, G., and Guarini, A. (2019). Effects of Physical Exercise Intervention on Psychological and Physical Fitness in Lymphoma Patients. Medicina, 55.","DOI":"10.3390\/medicina55070379"},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1159\/000489252","article-title":"Improvable Lifestyle Factors in Lymphoma Survivors","volume":"139","author":"Minoia","year":"2018","journal-title":"Acta Haematol."}],"container-title":["Cancers"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6694\/14\/6\/1439\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T22:34:41Z","timestamp":1760135681000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6694\/14\/6\/1439"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,3,10]]},"references-count":77,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2022,3]]}},"alternative-id":["cancers14061439"],"URL":"https:\/\/doi.org\/10.3390\/cancers14061439","relation":{},"ISSN":["2072-6694"],"issn-type":[{"value":"2072-6694","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,3,10]]}}}