ASSESSMENT OF BONE MINERAL DENSITY IN PATIENTS WITH HODGKIN’S LYMPHOMA

Currently, Hodgkin’s lymphoma (HL) is considered as a potentially curable disease. The polychemotherapy including various combinations of cytostatic drugs and glucocorticoids appears the standard of treatment in patients with HL. Patients with early stage disease (stage I to II) receive several cycles of chemotherapy followed by the radiotherapy. The possibility of achieving persistent disease-free survival poses a problem of ensuring a satisfactory quality of life and preventing the long-term consequences of antitumor therapy. One of those consequences may be a change in bone mineral density (BMD). Aim of the study was to assess the BMD in patients with HL. Material and methods. BMD was measured by dual-energy X-ray absorbtiometry using a stationary LunarProdigy bone densitometer (GE, USA). The Russian FRAX model was used in this study. The model uses clinical data to calculate the major low-energy fractures and the hip fractures. Results. The decreased BMD was revealed in 36 observed HL subjects (48.6 %). Patients with osteoporosis were generally older, had a lower body mass index as compared to patients with normal BMD (p < 0.05). Based on FRAX assessment, the 10-year risk of major low-energy fractures and the hip fractures was expectedly higher in patients with osteoporosis and osteopenia as compared to subjects with normal BMD (p < 0.05). More patients with radiotherapy in anamnesis had decreased BMD compared to patients who received chemotherapy only (χ² = 5.47; р = 0.0194). More than half of the patients (59.1 %) receiving regimens containing glucocorticosteroids had BMD decrease. A comparative analysis revealed that patients younger than 50 years old had lower values of BMD and Z-score of the lumbar spine in the early stages of HL as compared to patients with stage III-IV. In turn, in patients older 50 years and postmenopausal women at the early stages of HL was a significant decrease of BMD and T-score of the femoral neck as compared to patients with advanced stages of the disease. This research suggests that the decrease in BMD in stages I-II of HL can be associated with radiotherapy as the generally accepted standard for the treatment of early stages of the disease.