Impaired bone mineral density in pediatric and adolescent patients with bone sarcomas

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Abstract

For modern treatment schemes for bone sarcomas (BS), overall survival of children and adolescents is 60–70 %. This treatment can be accompanied by disruption of intraosseous metabolism which leads to decreased bone mineral density (BMD). Clinical equivalents of decreased BMD are osteoporosis/osteopenia which are reported in 45 % of patients cured of various malignant neoplasms. Children and adolescents with BS have higher incidence of osteoporosis (43–65 % of cases) compared to patients with other types of malignant tumors.

Aim. To determine the rate of BMD abnormalities and risk factors of osteoporosis in children and adolescents who completed BS therapy.

Results of scientific articles published in the eLIBRARY, PubMed, Scopus databases, as well as on the Research Gate, Google Scholar platforms were analyzed. In patients with BS, the following main etiologic and pathogenetic mechanisms of BMD decrease were identified: tumor process extent, mutilating surgical interventions, implantation of various implants, limitation of mobility, administration of cytostatic drugs, high-dose radiotherapy, genetic predisposition. BMD abnormalities and bone fractures develop even in unaffected by the tumor parts of the skeleton. Considering high risk of osteoporosis in patients with BS, it is important to start diagnostic process and correction of this complication as soon as possible after the start of antitumor therapy, as well as monitor BMD even in patients in long-term remission.

About the authors

Elena V. Zhukovskaya

Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, Ministry of Health of Russia

Author for correspondence.
Email: elena_zhukovskay@mail.ru
ORCID iD: 0000-0002-6899-7105

Medical and Rehabilitation Research Center “Russian field”

Russian Federation, Plot 1 Chekhov, village Grishenki, Moscow Region 142321

S. M. Chechelnitskaya

Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, Ministry of Health of Russia

Email: elena_zhukovskay@mail.ru
ORCID iD: 0000-0003-0808-2605

Medical and Rehabilitation Research Center “Russian field”

Russian Federation, Plot 1 Chekhov, village Grishenki, Moscow Region 142321

G. V. Tereshchenko

Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, Ministry of Health of Russia

Email: elena_zhukovskay@mail.ru
ORCID iD: 0000-0001-7317-7104

Medical and Rehabilitation Research Center “Russian field”

Russian Federation, Plot 1 Chekhov, village Grishenki, Moscow Region 142321

T. V. Nasedkina

Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, Ministry of Health of Russia; Engelhardt Institute of Molecular Biology, Russian Academy of Sciences

Email: elena_zhukovskay@mail.ru
ORCID iD: 0000-0002-2642-4202

Medical and Rehabilitation Research Center “Russian field”

Russian Federation, Plot 1 Chekhov, village Grishenki, Moscow Region 142321; 32 Vavilova St., Moscow 119991

A. V. Petrichenko

Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, Ministry of Health of Russia; Engelhardt Institute of Molecular Biology, Russian Academy of Sciences; Russian Medical Academy of Continuing Professional Education, Ministry of Health of Russia; N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia

Email: elena_zhukovskay@mail.ru
ORCID iD: 0000-0001-6876-7898

Medical and Rehabilitation Research Center “Russian field”

Russian Federation, Plot 1 Chekhov, village Grishenki, Moscow Region 142321; 32 Vavilova St., Moscow 119991; Bld. 1, 2/1 Barricadnaya St., 123995 Moscow; 1 Ostrovityanova St., Moscow 117513

A. F. Karelin

Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, Ministry of Health of Russia

Email: elena_zhukovskay@mail.ru
ORCID iD: 0000-0003-0533-9233

Medical and Rehabilitation Research Center “Russian field”

Russian Federation, Plot 1 Chekhov, village Grishenki, Moscow Region 142321

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