Evaluating the impact of lymphoma treatments on bone health

This study evaluated the impact of first-line lymphoma treatments including high-dose prednisolone (Deltasone) on bone health in patients with non-Hodgkin lymphoma (NHL). This study concluded that first-line lymphoma treatments increased the risk of osteoporosis in patients with lymphoma, especially for women and elderly patients.

Glucocorticoids are drugs that help lower inflammation. These drugs are often used during chemotherapy treatment to help reduce some of the side effects, such as nausea and fatigue. However, long-term use of these medications is associated with a high risk of developing osteoporosis.

Osteoporosis is a condition where the bones become brittle and fragile. As a result, a fall or even mild activity, such as bending over, can cause bone fractures. Prednisolone is a glucocorticoid that is often included in first-line chemotherapy for lymphoma. The long-term effects of prednisolone treatment in patients with NHL remain under investigation.

This study had 2589 patients with NHL. 1972 patients (76%) had diffuse large B-cell lymphoma (DLBCL). 617 patients (24%) had follicular lymphoma (FL). All patients received chemotherapy regimens that included prednisolone. Patients were followed for an average of 5.4 years. 12,945 healthy volunteers were also included (control group).

Overall, patients with lymphoma had a 1.61-fold higher risk of osteoporosis compared to the control group. The risk of osteoporosis was higher 5 years later (10.0% vs. 6.8%) and 10 years later (16.3% vs. 13.5%) in patients with lymphoma.

Certain factors were associated with a higher risk of osteoporosis. Female patients with lymphoma had a much higher risk compared to the control group. This was true 5 years (16.1% vs. 10.6%) and 10 years after treatment (25.7% vs. 19.5%). Patients older than age 70 also had a higher 5-year risk compared to the control group (16.6% vs. 11.3%).

Patients who did not develop osteoporosis during the first two years after treatment were not at higher risk of developing it later.

This study concluded that high-dose prednisolone or other steroids in lymphoma treatments increased the risk of osteoporosis in patients with lymphoma, especially for women and elderly patients. The authors suggest that check-ups for osteoporosis within the first two years after treatment may help.

This study was conducted in the Netherlands. Therefore, the results may not apply to all populations. Also, whether patients took calcium or vitamin D supplements was unknown. This may affect the results.

Talk to your doctor about your potential risk of developing osteoporosis.