Денситометрическая оценка минеральной плотности костной ткани у пациентов молодого возраста с лимфомой Ходжкина

Abstract

Hodgkin’s lymphoma is more often diagnosed in young patients. One of the late complications of pathogenetic therapy of Hodgkin’s lymphoma is osteopenia/osteoporosis and the increased risk of low-energy fractures. Conducting densitometry in young patients in order to assess the bone tissue condition is advisable, but its clinical assessment remains difficult. At the same time, early diagnosis and prevention of bone mineral density decrease in patients with Hodgkin’s lymphoma who received antitumor therapy are very relevant. The purpose — to study the features of densitometric indicators for the verification of osteopenia / osteoporosis in young patients with Hodgkin’s lymphoma. Material and methods. 63 people were included in the study, 33 of them were patients with Hodgkin’s lymphoma who received pathogenetic therapy, and 30 people the control group — healthy volunteers. Bone mineral density was measured in all patients using the HOLOGIC (Hologic Inc., Bedford) in the lumbar spine (L1–L4) and in the hip area (the total area of the hip and hip neck). Criteria such as minimum bone mineral density, T-criteria and Z-criteria for young patients with Hodgkin’s lymphoma were determined. Results. In the group of patients with Hodgkin’s lymphoma, a decrease in bone mineral density is significantly more often recorded in all measurement areas, as well as the Z-criterion in the lumbar spine. Regretfully, in young patients the T-criterion can only be used given a more intensive mineralization of bone tissue than in older people and the presence of additional risk factors for osteoporosis (PCTs, glucocorticosteroids, decreased androgenic and fertile function). In patients with HL who received pathogenetic therapy, a decrease in the T-criterion to osteopenia is more often observed in the proximal femur. Conclusion. In many cases, modern capabilities for osteoporosis diagnostic allow correcting mineral metabolism in bone tissue and preventing the development of complications in young patients with Hodgkin’s lymphoma.