Radiologic and morphometric criteria of osteoporotic changes in patients with diffuse large b-cell lymphoma

Authors

  • P. A. CHUKUR I. Horbachevsky Ternopil National Medical University

DOI:

https://doi.org/10.11603/2414-4533.2023.3.14113

Keywords:

computed tomography, morfometry, bone mineral density, osteoporosis, diffuse large B-cell lymphoma

Abstract

The aim of the work: to develop radiologic and morphometric criteria for osteoporotic changes in patients with lymphomas undergoing chemotherapy courses.

Materials and Methods: The results of the examination and treatment of 115 patients with diffuse large B-cell lymphoma were analyzed. The average age was (57.86±1.40) years. The determination of bone mineral density of the lumbar vertebrae (L1–L5) was performed in Hounsfield units in a bone window using axial computed tomography images at the diagnostic stage and after completing chemotherapy courses. Morphometric measurements of the anterior, posterior, and middle vertebral body heights were determined using sagittal computed tomography slices.

Results and Discussion. At the diagnostic stage, normal bone mineral density was found in 26.09 % of patients, osteopenia in 52.17 %, and osteoporosis in 21.74 %. In men, the average values were characteristic of normal bone density, while in women, osteopenia predominated. After completing chemotherapy, normal bone density was found in 16.52 % of patients, osteopenia in 29.57 %, and osteoporosis in 53.91 %. In men, the average values corresponded to osteopenic changes, while in women, it indicated osteoporosis. Morphometric analysis at the diagnostic stage revealed deformations of the vertebral bodies in 22.61 % of patients: moderate deformation in 12.17 %, moderate in 6.96 %, severe in 3.48 %. An increase in the number of vertebral body deformations was observed in 53.85% of patients after treatment. Comparative assessment of structural and functional parameters of bone tissue depending on the treatment protocol showed a significant decrease in indicators by 24.49 % for the CHOP protocol and 21.25 % for the R-CHOP protocol. X-ray and morphometric criteria for osteoporotic changes in bone tissue have been developed for early diagnosis of osteoporosis and preventive measures in oncohematological patients.

References

Gregson, C.L., Armstrong, D.J., Bowden, J. (2022). UK clinical guideline for the prevention and treatment of osteoporosis: Archives of Osteoporosis, 143-149. DOI: https://doi.org/10.1007/s11657-022-01061-5

LeBoff, M.S., Greenspan, S.L., Insogna, K.L. (2022). The clinician’s guide to prevention and treatment of osteoporosis. Osteoporosis International, 33 (10), 2049-2102. DOI: https://doi.org/10.1007/s00198-021-05900-y

Bodden, J., Sun, D., Joseph, G.B. (2021). Identification of non-Hodgkin lymphoma patients at risk for treatment-related vertebral density loss and fractures. Osteoporosis International, 32 (2), 281-291. DOI: https://doi.org/10.1007/s00198-020-05577-9

Zhulkevych, I.V., Chukur, P.A. (2023). Zminy strukturno-funktsionalnoho stanu kistkovoi tkanyny u khvorykh na nekhodzhkinski limfomy v zalezhnosti vid typu ta tryvalosti khimioterapii [Changes in the structural and functional state of bone tissue in patients with non-Hodgkin's lymphoma depending on the type and duration of chemotherapy]. Zdobutky klinichnoi i eksperymentalnoi medytsyny – Achievements of Clinical and Experimental Medicine, 1, 112-122 [in Ukrainian].

Morgan, S.L., Prater, G.L. (2017). Quality in dual-energy X-ray absorptiometry scans. Bone, 104, 13-28. DOI: https://doi.org/10.1016/j.bone.2017.01.033

Li, N., Li, X. M., Xu, L. (2013). Comparison of QCT and DXA: Osteoporosis detection rates in postmenopausal women. International Journal of Endocrinology. 2013, 10-15. DOI: https://doi.org/10.1155/2013/895474

Candelaria, M., Oñate-Ocaña, L.F., Corona-Herrera, J. (2019). Clinical Characteristics of Primary Extranodal versus Nodal Diffuse Large B-Cell Lymphoma: A Retrospective Cohort Study in a Cancer Center. Revista de Investigación Clínica, 71 (5), 349-358. DOI: https://doi.org/10.24875/RIC.19003027

Genant, H.K., Wu, C.Y., Kuijk, C. van. (1993). Vertebral fracture assessment using a semiquantitative technique. Journal of Bone and Mineral Research: The Official Journal of the American Society for Bone and Mineral Research, 8 (9), 1137-1148. DOI: https://doi.org/10.1002/jbmr.5650080915

Hendrickson, N.R., Pickhardt, P.J., Rio, A.M. Del. (2018). Bone Mineral Density T-Scores Derived from CT Attenuation Numbers (Hounsfield Units): Clinical Utility and Correlation with Dual-energy X-ray Absorptiometry. The Iowa Orthopaedic Journal, 38, 25-31.

Kaddu-Mulindwa, D., Lesan, V., Berdel, C. (2022). Significant reduced loss of bone mineral density after four vs. six cycles of R-CHOP: an analysis of the FLYER-trial. Leukemia & Lymphoma, 63 (2), 326-334. DOI: https://doi.org/10.1080/10428194.2021.1975193

Booth, S., Plaschkes, H., Kirkwood, A.A. (2020). Fractures are common within 18 months following first-line R-CHOP in older patients with diffuse large B-cell lymphoma. Blood Advan­ces, 4 (18), 4337-4346. DOI: https://doi.org/10.1182/bloodadvances.2020002553

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Published

2023-04-09

How to Cite

CHUKUR, P. A. (2023). Radiologic and morphometric criteria of osteoporotic changes in patients with diffuse large b-cell lymphoma. Hospital Surgery. Journal Named by L.Ya. Kovalchuk, (3), 100–106. https://doi.org/10.11603/2414-4533.2023.3.14113

Issue

No. 3 (2023)

Section

EXPERIENCE OF WORK

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Copyright (c) 2023 P. A. CHUKUR

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