REDUCED BONE-MINERAL DENSITY IN MEN FOLLOWING CHEMOTHERAPY FOR HODGKINS-DISEASE

We have measured bone mineral density (BMD) in 29 men, mean age 35.0 ( range 19.7-58.0) years, with testicular damage following MVPP or hybri d chemotherapy for Hodgkin's disease. Forearm cortical bone mineral co ntent (BMC) and lumbar spine and femoral neck integral BMD were measur ed 3.4 (1.1-6.8) years after completion of chemotherapy, and results e xpressed as Z (standard deviation) scores. There was a significant red uction in forearm cortical BMC (median BMC 1.727 g cm(-1) median Z-sco re -0.8, P<0.0005), in lumbar spine integral BMD (median BMD 1.141 g c m(-2), median Z-score -0.6, P<0.0005) and in femoral neck integral BMD (median BMD 0.991 g cm(-2), median Z-score -0.4, P<0.05). There was n o significant correlation between Z-score and time elapsed since compl etion of chemotherapy, and no significant difference in Z-score accord ing to type of chemotherapeutic regimen or number of cycles of chemoth erapy received. In conclusion, men who are in complete remission follo wing treatment of Hodgkin's disease have reduced cortical and trabecul ar BMD. Possible causes include mild hypogonadism secondary to chemoth erapy-induced impairment of Leydig cell function, a direct effect of c hemotherapy on bone, an effect of high-dose glucocorticoid on bone or an effect of Hodgkin's disease per se.