Evidence map›Paper›PMID 26851412›Full record

ArticleBone2016

Early injury to cortical and cancellous bone from induction chemotherapy for adolescents and young adults treated for acute lymphoblastic leukemia.

E Orgel, N M Mueske, T A L Wren, V Gilsanz, A M Butturini, D R Freyer, S D Mittelman

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Bone, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
13citing papers in PubMed, 1 pooled it
3.0field-weighted citation impact, top 10% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

13 citing papers in PubMed, 1 synthesis or guideline pooled it, 32 citations in OpenAlex.

  1. Pooled it
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  12. Bone morbidity in pediatric acute lymphoblastic leukemia.Annals of pediatric endocrinology & metabolism · 2020
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 3 institutions in 1 country.

E OrgelChildren's Center for Cancer and Blood Disease, Children's Hospital Los Angeles, 4650 Sunset Blvd, Los Angeles, CA 90027, USA; Jonathan Jaques Children's Cancer Center, Miller Children's Hospital Long Beach, 2801 Atlantic Avenue, Long Beach, CA 90806, USA; University of Southern California, Los Angeles, CA 90089, USA. Electronic address: eorgel@chla.usc.edu.
N M MueskeChildren's Orthopaedic Center, Children's Hospital Los Angeles, 4650 Sunset Blvd, Los Angeles, CA 90027, USA.
T A L WrenChildren's Orthopaedic Center, Children's Hospital Los Angeles, 4650 Sunset Blvd, Los Angeles, CA 90027, USA; University of Southern California, Los Angeles, CA 90089, USA.
V GilsanzDepartment of Radiology, Children's Hospital Los Angeles, 4650 Sunset Blvd, Los Angeles, CA 90027, USA; University of Southern California, Los Angeles, CA 90089, USA.
A M ButturiniChildren's Center for Cancer and Blood Disease, Children's Hospital Los Angeles, 4650 Sunset Blvd, Los Angeles, CA 90027, USA; University of Southern California, Los Angeles, CA 90089, USA.
D R FreyerChildren's Center for Cancer and Blood Disease, Children's Hospital Los Angeles, 4650 Sunset Blvd, Los Angeles, CA 90027, USA; University of Southern California, Los Angeles, CA 90089, USA.
S D MittelmanChildren's Center for Cancer and Blood Disease, Children's Hospital Los Angeles, 4650 Sunset Blvd, Los Angeles, CA 90027, USA; Center for Endocrinology, Children's Hospital Los Angeles, 4650 Sunset Blvd, Los Angeles, CA 90027, USA; University of Southern California, Los Angeles, CA 90089, USA.
University of Southern California · USChildren's Hospital of Los Angeles · USChildren's Center · US

Funding

Southern California Clinical and Translational Science InstituteUL1TR000130 · NCATS · UNIVERSITY OF SOUTHERN CALIFORNIA · PI BUCHANAN, THOMAS A · 2012 to 2015
$36.0M
Risk Factors for Osteoporosis in Children & Adolescents with MyelomeningoceleR01HD059826 · NICHD · CHILDREN'S HOSPITAL OF LOS ANGELES · PI WREN, TISHYA A L · 2010 to 2014
$2.4M
NCATS NIH HHS UL1 TR000130NICHD NIH HHS R01 HD059826
6 · The paper itself

Abstract

Diminished bone density and skeletal fractures are common morbidities during and following therapy for acute lymphoblastic leukemia (ALL). While cumulative doses of osteotoxic chemotherapy for ALL have been reported to adversely impact bone density, the timing of onset of this effect as well as other changes to bone structure is not well characterized. We therefore conducted a prospective cohort study in pre-adolescent and adolescent patients (10-21years) newly diagnosed with ALL (n=38) to explore leukemia-related changes to bone at diagnosis and the subsequent impact of the first phase of chemotherapy ("Induction"). Using quantitative computerized tomography (QCT), we found that pre-chemotherapy bone properties were similar to age- and sex-matched controls. Subsequently over the one month Induction period, however, cancellous volumetric bone mineral density (vBMD) decreased markedly (-26.8%, p<0.001) with sparing of cortical vBMD (tibia -0.0%, p=0.860, femur -0.7%, p=0.290). The tibia underwent significant cortical thinning (average cortical thickness-1.2%, p<0.001; cortical area-0.4%, p=0.014), while the femur was less affected. Areal BMD (aBMD) concurrently measured by dual-energy X-ray absorptiometry (DXA) underestimated changes from baseline as compared to vBMD. Biochemical evidence revealed prevalent Vitamin D insufficiency and a net resorptive state at start and end of Induction. Our findings demonstrate for the first time that significant alterations to cancellous and cortical bone develop during the first month of treatment, far earlier during ALL therapy than previously considered. Given that osteotoxic chemotherapy is integral to curative regimens for ALL, these results provide reason to re-evaluate traditional approaches toward chemotherapy-associated bone toxicity and highlight the urgent need for investigation into interventions to mitigate this common adverse effect.

Indexed as

AdolescentBiomarkersBone DensityCancellous BoneCase-Control StudiesCohort StudiesCortical BoneFemaleHumansInduction ChemotherapyMalePrecursor Cell Lymphoblastic Leukemia-LymphomaTibiaTomography, X-Ray ComputedYoung AdultBiomarkersAcute lymphoblastic leukemiaBoneBone mineral densityChemotherapyDXAQCT

Identifiers

PMID26851412
PMCPMC4795805
OpenAlexW2263366381

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.