Thyroid dysfunction is associated with osteoporosis in patients with Hodgkin’s lymphoma

Poster (download) Mariya S. Voytko1, Vadim V. Klimontov2, Tatyana I. Pospelova3, Olga N. Fazullina4, Alexander I. Autenshlyus51Novosibirsk State Medical University, voytko.marie@yandex.ru2Research Institute of Clinical and Experimental Lymphology, klimontov@mail.ru3Novosibirsk State Medical University, post_gem@mail.ru4Research Institute of Clinical and Experimental Lymphology, fazullina@ngs.ru5Novosibirsk State Medical University, post_gem@mail.ru Background and Aim: Radiation therapy (RT) is a cornerstone component of the treatment for many patients with Hodgkin\’s lymphoma (HL). Current treatment options for HL are mostly effective, but may have a negative pronounced damaging effect on some organs. Specifically, RT can induce thyroid dysfunction and decrease in bone mineral density (BMD). The aim of the study was to assess the prevalence of thyroid dysfunction in HL survivors and estimate its effect on BMD. Methods: The study included 160 patients with HL, from 18 to 65 years of age (median 42 years), observed in Hematology Center of Novosibirsk. The disease was staged according to the Ann Arbor staging system; 71 patients had limited stage (I-II) and 84 patients had advanced stage disease (stage III to IV). All subjects received first-line regimens. Neck and supraclavicular RT was performed in 96 (60%) individuals; the total dose was 30 Gy in 84 patients and 36 Gy in 11 ones. Thyroid hormones were measured by enzyme immunoassays. The BMD was assessed by dual-energy X-ray absorptiometry. Statistical data processing was performed using STATISTICA (StatSoft, Inc., USA). Results: The changes in thyroid function were revealed in 40 (25%) patients. Among them, primary hypothyroidism was verified in 30 subjects, including 18 individuals with subclinical hypothyroidism. Ten patients had central hypothyroidism. Thirty two patients had neck and supraclavicular RT in their anamnesis. In this subgroup, hypothyroidism was observed in 22 subjects with total focal dose of 30 Gy and in 8 subjects with the total focal dose of 36 Gy. The decrease in BMD was revealed in 76 HL subjects (47.5%), 43 of them diagnosed as having osteoporosis. The decline in BMD was more frequent in patients with hypothyroidism as compared to those without (П‡2=13.4, СЂ<0.001). Conclusion: Hypothyroidism is associated with decrease in BMD in patients with HL.

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