CHANGES IN THE STRUCTURAL AND FUNCTIONAL STATE OF BONE TISSUE IN NON-HODGKIN'S LYMPHOMA PATIENTS DEPENDING ON THE TYPE AND DURATION OF CHEMOTHERAPY
DOI:
https://doi.org/10.11603/1811-2471.2023.v.i1.13515Keywords:
osteoporosis, bone tissue, bone mineral density, computed tomography, lymphoma, treatment, chemotherapyAbstract
SUMMARY. Determination of influencing factors that lead to a decrease in the structural and functional state of bone tissue (SFSBT) is relevant for the prevention of the development of osteoporotic lesions and the prevention of secondary osteoporosis in patients with lymphoproliferative diseases.
The aim – to evaluate the SFSBT of the trabecular component of the lumbar spine in patients with non-Hodgkin's lymphoma (NHL) at the diagnostic stage (DE) and after completion of chemotherapy (CCT) depending on the protocol and duration of treatment.
Material and Methods. An analysis of the SFSBT of the lumbar vertebrae was performed according to standard scanning protocols on computer tomography in 55 patients who received chemotherapy according to the CHOP and R-CHOP protocols.
Results. In patients with NHL, on DE and CCT, a more significant decrease in SFSBT was determined in the group of patients treated according to the R-CHOP protocol compared to the group treated according to the CHOP protocol. When assessing the effect of chemotherapeutic drugs, a reliable relationship was established between the total dose of doxorubicin and cyclophosphane and bone mineral density (BMD) of the L1–L3, L5 area (r=-0.36; r=-0.35; r=-0.41; r=-0.35, p<0.05), correlation with the total dose of vincristine in L1–L5 vertebrae (r=-0.39; r=-0.38; r=-0.44; r=-0.34; r=-0.40, p<0.05) and a reliable relationship between BMD and the total dose of prednisone in the area of L1, L2, L3, L5 (r=-0.36; r= -0.35; r=-0.41; r=-0.35) after PCT courses in NHL patients.
Conclusions. It was established that shorter courses of R-CHOP have the least effect on SFSCT in patients with NHL. A pronounced decrease in BMD occurs with long-term treatment according to the CHOP protocol. A reliable correlation between the number of chemotherapy courses and changes in BMD of the lumbar vertebrae in patients with NHL was established. A reliable correlation was found between the total dose of doxorubicin, cyclophosphane, vincristine and prednisolone and BMD of lumbar vertebrae of PCL.
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