Bone mineral density (BMD) in patients with lymphoma: The effects of chemotherapy, intermittent corticosteroids and premature menopause

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Abstract
Young women with a chemotherapy‐induced early menopause are theoretically at considerable risk of developing post‐menopausal osteoporosis with problems developing earlier and more severely. In this study bone mineral density (BMD) measurements were made, using a dual‐energy X‐ray absorptiometer (DXA), at the spine and hip of 50 young women who had been treated for lymphoma, 24 of whom were post‐menopausal and 78, healthy age‐matched controls. On analysis of the results, there was no significant difference between the control group and the 26 post‐treatment, pre‐menopausal patients, but the BMD levels were significantly lower than the controls in the post‐menopausal group particularly in 16 patients who had been menopausal greater than 18 months. The results confirm that these young women with treatment‐induced premature menopause are at considerable risk of developing osteoporotic problems. Early recognition of this is important so that preventative measures with hormone replacement therapy can be initiated where this is safely possible. The results also indicate that chemotherapy for lymphoma (cytotoxics and high dose intermittent steroids), are unlikely to contribute directly to the lowering of the BMD of these patients.