Bone mineral density changes in patients with Hodgkin's lymphoma

The aim: to identify the factors affecting bone mineral density (BMD) in patients with Hodgkin's lymphoma (HL). Methods: The study included 38 patients, from 19 to 70 years of age (median 49 years). The disease was staged according to the Ann Arbor staging system: 16 patients had early stage disease and 22 patients had advanced stage disease (stage III to IV). Thirty four subjects received first- and second-line regimens (ABVD, BEACOPP, DHAP). Four patients received other regimens, including DAL-HD-2002, ProMACE-CytaBOM, COPDIC, and COPP. Radiotherapy was performed in 28 individuals. High dose therapy with autologous stem cells rescue (HDCT-ASCT) was conducted in one patient. The BMD was assessed by dual-energy X-ray absorptiometry (DXA). Results: The decreased BMD was revealed in 20 observed HL subjects (52.6%). The decline in BMD was more frequent in patients aged ≥ 50 years as compared to younger ones (χ2 = 5.75; p = 0.02). More patients with radiotherapy in anamnesis had decreased BMD compared to patients who received chemotherapy only (χ2 = 8.82; p = 0.003). Osteopenia was found in patient with HDCT- ASCT. Nineteen patients received regimens containing glucocorticoids had decrease in BMD. Based on FRAX assessment, the 10-year risk of major low-energy fractures and the hip fractures was expectedly higher in patients with osteoporosis and osteopenia as compared to subjects with normal BMD (p <; 0.05). Conclusion: The decrease in BMD is associated with radiotherapy and chemotherapy with glucocorticoids in patients with HL.