Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Bone Mineral Density and Frailty in ALL Survivors

Clin Oncol; ePub 2016 Mar 21; Wilson, et al

Survivors of childhood acute lymphoblastic leukemia (ALL) should receive counseling regarding lifestyle and undergo screening for hormonal deficits to minimize the risk of low bone mineral density (BMD) and frailty. This according to a study of 862 patients who survived ALL. Researchers found:

• 30% of survivors met criteria for low BMD, and 18.6% for frailty/prefrailty.

• After adjusting for body mass index, low BMD was associated with growth hormone deficiency (GHD; OR=1.59), and current smoking (OR=1.71) among men.

• Among women, low BMD was associated with GHD (OR=2.18) and moderate alcohol consumption (OR=2.09).

• After adjusting for current age, odds of frailty/prefrailty were increased among men with GHD (OR=2.97) and those who smoked (OR=3.26); there were no significant associations among women.

Citation: Wilson CL, Chemaitilly W, Jones KE, et al. Modifiable factors associated with aging phenotypes among adult survivors of childhood acute lymphoblastic leukemia. [Published online ahead of print March 21, 2016]. Clin Oncol. doi:10.1200/JCO.2015.64.9525.

Must Reads in ALL

Immune system changes play a role in AML relapse, Christopher MJ et al. N Engl J Med. 2018 Oct 31. doi: 10.1056/NEJMoa1808777.

CAR T-cell cost effectiveness in ALL, Whittington MD et al. JAMA Pediatr. 2018 Oct 8. doi: 10.1001/jamapediatrics.2018.2530

CAR T induced resistance in ALL, Ruella M et al. Nat Med. 2018 Oct 1. doi: 10.1038/s41591-018-0201-9

ALL complications carry cognitive risks, Cheung YT et al. JAMA Pediatr. 2018 Sep 24. doi:10.1001/jamapediatrics.2018.2500.