Investigation of the Relationship Between and Gene Polymorphisms and Development of Treatment-Related Bone Complications in Children with Acute Lymphoblastic Leukemia

Overview

Journal Turk J Haematol

Specialty Hematology

Date 2018 Sep 26

PMID 30251958

Citations 1

Authors

Melek Erdem

Ozlem Tufekci

Sefa Kizildag

Sebnem Yilmaz

Deniz Kizmazoglu

Berna Eroglu Filibeli

Hale Oren

Affiliations

Soon will be listed here.

Abstract

Objective: In acute lymphoblastic leukemia (ALL), various clinical risk factors and genetic predispositions contribute to the development of bone complications during and after chemotherapy. In this study, we aimed to investigate whether vitamin D receptor () and collagen protein Sp1-binding site gene polymorphisms, which are important in bone mineral and matrix formation, have effects on the development of bone abnormalities in childhood ALL survivors.

Materials And Methods: Fifty children with ALL who were treated with the ALL Berlin-Frankfurt-Muenster-95 protocol between 1998 and 2008 and were followed for at least 7 years were enrolled. The control group consisted of 96 healthy children. and Sp1-binding site gene polymorphisms were analyzed by polymerase chain reaction and restriction fragment length polymorphism. Bone mineral density (BMD) and markers of bone metabolism were all noted. All patients who presented with pain in the joints were examined for bone pathologies while on chemotherapy or during long-term follow-up.

Results: Low BMD (16%), osteoporosis (12%), and osteonecrosis (8%) were present in a total of 18 patients (36%). The frequency of osteonecrosis and total bone abnormalities was significantly higher in children aged ≥10 years (p=0.001). The risk of low BMD and osteonecrosis was higher in those with vitamin D deficiency. Only the Sp1-binding site gene polymorphism showed a significant association in ALL patients with osteonecrosis.

Conclusion: The development of therapy-induced bone mineral loss and osteonecrosis in children with ALL is frequent and the risk is especially higher in children aged ≥10 years and with vitamin D deficiency. The association between Sp1-binding site gene polymorphisms and osteonecrosis has to be assessed in a larger group of ALL survivors.

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