EFFECT OF CHLORAMBUCIL ON BONE-MINERAL DENSITY IN THE COURSE OF CHRONIC LYMPHOID LEUKEMIA

The purpose of this work was to study the effects of chronic lymphoid leukemia (CLL) and its treatments on bone mineral density (BMD). Lumba r and femoral BMD was measured by X-ray absorptiometry in 50 (32 M, 18 F, median age 65, range age: 47-87 yr) CLL patients. In order to gaug e the respective effects of CLL and corticoids on bone mass, 31 CLL pa tients under treatment were compared with 31 controls on cortisone. Ni neteen untreated patients with CLL were compared with controls devoid of osteopenia risk factor. There was no significant difference regardi ng lumbar and femoral BMD between the untreated patients with CLL and the healthy controls. An increase in lumbar and femoral BMD was noted in the treated CLL group compared with the controls on cortisone (lum BMD: 1.018 vs. 0.861 g/cm(2), p=6.10(-4); fem BMD: 0.773 vs. 0.699 g/c m(2) p=0.037). This increase was observed only in patients who had rec eived chlorambucil (lum BMD: 1.066 vs. 0.861 g/cm(2), p=0.10(-4); fem BMD: 0.806 vs. 0.699 g/cm(2), p=4.10(-3)), whereas there was no differ ence between the CLL patients treated without chlorambucil and the con trols on cortisone. Multiple linear regression analysis confirmed the marked effect of chlorambucil (r=0.3715, p<10(-3)) on BMD increase in the course of CLL.