ASSESSMENT OF BONE TISSUE MINERAL DENSITY ACCORDING COMPUTER TOMOGRAPHY DATA AND RISK DETERMINATION OF OSTEOPOROTIC FRACTURES IN PATIENTS WITH DIFFUSE LARGE B-CELL CELL LYMPHOMA
DOI:
https://doi.org/10.11603/1811-2471.2021.v.i2.12205Keywords:
diffuse large B-cell lymphoma, non-Hodgkin's lymphoma, chemotherapy, bone mineral densityAbstract
In Ukraine, there is a tendency to increase the incidence of non-Hodgkin's lymphoma (NHL), so the study of changes in bone mineral density (BMD) associated with lymphoproliferative diseases and long-term effects of anticancer therapy are relevant and necessary for the prevention of osteoporotic fractures.
The aim – to determine the risk of secondary osteoporotic fractures, the risk of bone marrow involvement and assess the dynamics of changes in the BMD of the lumbar spine in patients with diffuse larg eB-cell lymphoma (DLBCL) at the diagnostic phase (DP) and after chemotherapy (ACT).
Material and Methods. The mineral density of the trabecular bone tissue of the lumbar vertebrae (L1-L5) was determined using the ROI function in the program Radiant Dicom Viewer in the bone window in 56 patients: 26 women and 30 men (mean age – 55.96±2.11 g). Statistical analysis was performed according to the robust Leven-Brown-Forsythe criterion.
Results. In the gender comparison for DP, according to the FRAX and QFracture questionnaires, a higher risk of osteoporotic fracture was determined in women on all indicators: FRAX – the main osteoporotic risk of 43.21 % and the risk of femoral fracture 59.35 %; QFracture – 59.86 % risk of hip, wrist, shoulder or spine fracture and 60.12 % risk of hip fracture. Decreased BMD was observed in both DP and ACT in men and women. In men, the most significant decrease in BMD by 19.59 % was observed in L4, in women – in L3 by 13.11 %, p<0.05.
Conclusions. According to the results of the FRAX and QFracture questionnaires, an increased risk of osteoporotic fractures on DP was determined in all examined patients with DLBCL. The condition of the lumbar vertebrae in the CT series in patients with DLBCL for DP in women was significantly lower than in men. ACT there was a decrease in BMD in both men and women, no significant difference between groups of patients was found.
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