Increased risk of osteoporosis following commonly used first-line treatments for lymphoma: a Danish Nationwide Cohort Study

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  • Joachim Baech, Unit of Epidemiology and Biostatistics, Aalborg University Hospital, Aalborg, Denmark.
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  • Steen Moeller Hansen, Unit of Epidemiology and Biostatistics, Aalborg University Hospital, Aalborg, Denmark.
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  • Lasse Hjort Jakobsen, Department of Clinical Epidemiology, Institute of Clinical Medicine, Aarhus University Hospital, Aalborg, Denmark Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark Department of Anaesthesia and Intensive Care Medicine, Aalborg University Hospital, Aalborg, Denmark Aalborg Atrial Fibrillation Study Group, Aalborg, Denmark.
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  • Andreas K Øvlisen, Department of Clinical Epidemiology, Institute of Clinical Medicine, Aarhus University Hospital, Aalborg, Denmark Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark Department of Anaesthesia and Intensive Care Medicine, Aalborg University Hospital, Aalborg, Denmark Aalborg Atrial Fibrillation Study Group, Aalborg, Denmark.
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  • Marianne Tang Severinsen, Aalborg Universitet, Department of Clinical Epidemiology, Institute of Clinical Medicine, Aarhus University Hospital, Aalborg, Denmark Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark Department of Anaesthesia and Intensive Care Medicine, Aalborg University Hospital, Aalborg, Denmark Aalborg Atrial Fibrillation Study Group, Aalborg, Denmark., Department of Hematology, Aalborg University Hospital, Aalborg, Denmark ; Clinical Cancer Research Center, Aalborg University Hospital, Aalborg, Denmark.
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  • Peter de Nully Brown, Department of Hematology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
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  • Peter Vestergaard, Department of Endocrinology and Internal Medicine (MEA), Aarhus University Hospital, Aarhus, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark., Steno Diabetes Center, North Jutland, Aalborg University Hospital, Denmark
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  • Henrik Frederiksen, Department of Hematology, Odense University Hospital, Odense, Denmark., Department of Hematology and the Academy of Geriatric Cancer Research (AgeCare), Odense University Hospital, DK-5000, Odense C, Denmark.
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  • Judit Jørgensen
  • Jørn Starklint
  • Pär Josefsson, Department of Hematology, Herlev Hospital, Copenhagen University Hospital, Herlev Ringvej 75, DK-2730 Herlev, Denmark.
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  • Troels Hammer, Department of Hematology, Zealand University Hospital, Køge, Denmark.
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  • Michael Roost Clausen
  • Christian Torp-Pedersen, Department of Clinical Epidemiology, Institute of Clinical Medicine, Aarhus University Hospital, Aalborg, Denmark Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark Department of Anaesthesia and Intensive Care Medicine, Aalborg University Hospital, Aalborg, Denmark Aalborg Atrial Fibrillation Study Group, Aalborg, Denmark.
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  • Paw Jensen, Aalborg Universitet, Department of Clinical Epidemiology, Institute of Clinical Medicine, Aarhus University Hospital, Aalborg, Denmark Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark Department of Anaesthesia and Intensive Care Medicine, Aalborg University Hospital, Aalborg, Denmark Aalborg Atrial Fibrillation Study Group, Aalborg, Denmark., Department of Hematology, Aalborg University Hospital, Aalborg, Denmark ; Clinical Cancer Research Center, Aalborg University Hospital, Aalborg, Denmark.
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  • Tarec Christoffer El-Galaly, Aalborg Universitet, Department of Clinical Epidemiology, Institute of Clinical Medicine, Aarhus University Hospital, Aalborg, Denmark Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark Department of Anaesthesia and Intensive Care Medicine, Aalborg University Hospital, Aalborg, Denmark Aalborg Atrial Fibrillation Study Group, Aalborg, Denmark., Department of Hematology, Aalborg University Hospital, Aalborg, Denmark ; Clinical Cancer Research Center, Aalborg University Hospital, Aalborg, Denmark.

High-dose prednisolone is used in first-line treatment for lymphoma, but the potential adverse impact on bone health is unclear. Danish patients with diffuse large B-cell lymphoma or follicular lymphoma diagnosed between 2000 and 2012 were matched to the background population. Osteoporotic events (osteoporosis treatment or low-energy fracture) were identified using the Danish National Patient Registry and Prescription Registry. In total, 2589 patients and 12,945 controls were included. Lymphoma patients had increased risk of osteoporotic events compared to the matched population (hazard ratio 1.61 [95% confidence interval 1.40;1.84]). The 5- and 10-year cumulative risks of osteoporotic events for lymphoma patients were 10.0% [8.6;11.4] and 16.3% [13.8;18.7], whereas corresponding risks in the background population were 6.8% [6.3;7.3] and 13.5% [12.4;14.6]. Patients without osteoporotic event in the first two years after treatment were not at higher risk of osteoporotic events in subsequent years. Risk factors for osteoporotic events were female sex and age >70 years.

OriginalsprogEngelsk
TidsskriftLeukemia and Lymphoma
Vol/bind61
Nummer6
Sider (fra-til)1345-1354
Antal sider10
ISSN1042-8194
DOI
StatusUdgivet - jun. 2020

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