Clinical characteristics, parameters of disease activity and bone health.

<p>Mean ± SD, (range) are displayed. Followed by the number of patients examined if different from total number. (Pubic hair stage SDS (PH SDS), testicular volume/breast development stage SDS (TV/breast stage SDS), Lactate dehydrogenase (LDH), bilirubin (bili), reticulocytes (retic), 25-OH vitamin D (25-OH Vit D), 1,25-(OH)₂ vitamin D (1,25-OH Vit D), serum alkaline phosphatase (SAP), bone alkaline phosphatase (BAP), parathyroid hormone (PTH), urinary N-terminal telopeptide (NTX), urinary deoxypyridinoline (DPD), urinary calcium:creatinine ratio (Ca:Crea), osteocalcin, insulin-like growth factor 1 SDS (IGF-1 SDS), receptor activator of nuclear factor kappa-B (RANKL), osteoprotegerin (OPG) and dual-energy X-ray absorptiometry (DXA) Z-Score) were assessed. P-values refer to Kruskal Vallis test (HBSS vs Spherocytosis vs Healthy controls) if values are available for all 3 groups, or to Wilcoxon-two-sample test if values are available for HBSS and Spherocytosis only (in cursive).</p><p>Clinical characteristics, parameters of disease activity and bone health.</p

Serum levels of 25-OH vitamin D levels positively correlate with calcium to creatinine ratio in urine (<i>P</i> = 0.03, r = 0.36) in patients with hemolytic anemia.

<p>The predicted values based on bivariate regression are indicated as solid line.</p

Pediatric Survivors of Retinoblastoma Are at Risk for Altered Bone Metabolism After Chemotherapy Treatment Early in Life

<div><p>Survivors of childhood cancer frequently suffer from endocrine late effects, which are, at least partly, attributed to toxic effects of chemotherapy. Treatment of retinoblastoma typically involves chemotherapy at a very young age. The authors conducted a cross-sectional study to assess bone health in a pediatric cohort of 33 survivors of retinoblastoma (mean age: 4.4 years) who had undergone chemotherapy treatment at an especially young age (mean age: 0.76 years). Of these patients, 14 had unilateral and 19 bilateral retinoblastoma. Polychemotherapy consisted of treatment with cyclophosphamide, etoposide, vincristine, and carboplatin. Ten patients had undergone external beam radiotherapy. Clinical and biochemical parameters of growth, pubertal development, and bone health were obtained. A vitamin D deficiency was found in 51.7% of the patients, and 13.7% of patients displayed severe vitamin D deficiency. Secondary hyperparathyroidism and altered readings for bone formation or resorption markers were present in 15%. Nine percent reported bone pain or experienced fractures of the long bones after primary diagnosis. No difference between children with bilateral and unilateral disease or irradiated versus nonirradiated children was observed. The parameters of thyroid function, growth, and pubertal development were within age-appropriate norms in almost all children. In conclusion, altered parameters of bone health can be present in survivors of retinoblastoma at a young age and warrant regular follow-up in these children. The endocrine hypothalamic-pituitary axes, however, were not impaired at this early age in this group of survivors of retinoblastoma.</p></div

Serum 25-OH vitamin D levels are significantly lower in patients who report bone pain (back pain and/or knee pain with exercise) than in patients without reported bone pain (left).

<p>Statistically significant differences between the groups, determined via Mann-Whitney test, are indicated with asterisks (*: <i>P</i><0.05).</p

Positive association of BMD values obtained via BoneXpert and pQCT (XCT 900 Stratec®).

<p>A) BHI readings obtained using BoneXpert showed a positive correlation with BMD readings at the distal radius as measured via pQCT (XCT 900 Stratec®; r = 0.39; P < 0.0001). B) Accordingly, the SDS of the pQCT method (QCTOT SDS total, vertical axis) and the BoneXpert (BHI SDS, horizontal axis) were positively correlated (r = 0.3; P = 0.003). The predicted values based on bivariate regression analysis are indicated as a solid line. The dashed lines represent the 95% confidence interval.</p

Results of the DXA measurements.

<p>Results of the DXA measurements.</p

Results of the pQCT readings.

<p>Results of the pQCT readings.</p

Descriptive statistics of relevant patient clinical data.

<p>Descriptive statistics of relevant patient clinical data.</p

Positive association of BMD values obtained via BoneXpert and DXA scan.

<p>A) BMD readings of the lumbar spine (L1-L4) obtained by Lunar Prodigy (GE Healthcare) as a function of BHI obtained by BoneXpert (r = 0.73; P < 0.0001). B) Age-adjusted DXA Z-scores as a function of BHI SDS obtained via BoneXpert (r = 0.23; P = 0.02). C) DXA-Z scores, adjusted for patient height (HAZ) as a function of BHI SDS using BoneXpert (r = 0.27; P < 0.0001). For all figures, the predicted values based on bivariate regression analysis are indicated as solid line. The dashed lines represent the 95% confidence interval.</p