Bone mass and body composition after cessation of therapy for childhood cancer

Our aim was to review current information on body composition and bone mass after cessation of therapy for childhood cancer and to present preliminary data on body composition and bone mass in a group of Danish survivors of c hildhood leukaemia or lymphoma. Elevated body-mass index (weight/height(2); BMI) is frequent after treatment for childhood acute lymphoblastic leukaem ia. BMI increases during therapy or within the first year after therapy and remains abnormal thereafter. Treatment with corticosteroids, abnormal grow th-hormone secretion after treatment with cranial irradiation (CI) or corti costeroids, younger age at diagnosis, or female gender were risk factors fo r elevated BMI in earlier studies. We evaluated 185 survivors of childhood leukaemia or lymphoma by dual-energy X-ray absorptiometry scanning. We foun d elevated whole-body relative fat mass, which was associated with CI. Othe r studies found reduced bone mass in the radius, the lumbar spine and the w hole body after treatment for childhood cancer. Growth-hormone deficiency t hat is not adequately corrected, CI, reduced height or reduced weight were risk factors for reduced bone mass. In our 185 participants, the whole-body bone mass was also reduced significantly compared with reference values. C I and older age at follow-up were risk factors for reduced bone mass. We co nclude that the elevated relative fat mass and reduced bone mass seen after treatment for childhood leukaemia or lymphoma is associated mainly with CI . (C) 1998 Wiley-Liss, Inc.