Effect of vitamin K2 and vitamin D3 on bone mineral density in children with acute lymphoblastic leukemia: a prospective cohort study
Author:
Solmaz Ismail12, Ozdemir Mehmet Akif1, Unal Ekrem1, Abdurrezzak Ummuhan3, Muhtaroglu Sebahattin4, Karakukcu Musa1
Affiliation:
1. Division of Pediatric Hematology and Oncology, Department of Pediatrics, Faculty of Medicine , Erciyes University , Kayseri , Turkey 2. Department of Pediatric Neurology , Hacettepe University , Ankara , Turkey 3. Department of Nuclear Medicine, Faculty of Medicine , Erciyes University , Kayseri , Turkey 4. Department of Biochemistry, Faculty of Medicine , Erciyes University , Kayseri , Turkey
Abstract
Abstract
Objectives
Current treatment protocols in acute lymphoblastic leukemia (ALL) are associated with high remission rates and long life expectancy, enhancing the importance of quality of life and prevention of treatment-related complications in patient care. As osteoporosis is a frequent complication in patients under chemotherapy, we investigated the effect of vitamin K2 (100 mcg menaquinone-7) and vitamin D3 (10 mcg calcitriol) on bone metabolism in children with ALL.
Methods
Twenty-nine consecutive patients recently diagnosed with B precursor ALL (B-ALL) and treated according to the Turkish Acute Lymphoblastic Leukemia Berlin Frankfurt Münster 2000 protocol were randomly assigned into study and control groups. The study group (n=15, M/F: 8/7, age 1–14.5 years, mean 6.5 years) received vitamin K2 and vitamin D3 with their chemotherapy, while the control group (n=14, M/F 9/5, age 2–17 years, mean 7.1 years) received chemotherapy only. Serum calcium, phosphorus, magnesium, alkaline phosphatase, bone-specific alkaline phosphatase, uncarboxylated osteocalcin (ucOC), tartrate resistant acid phosphatase 5b, carboxyl terminal procollagen propeptide (PICP), osteoprotegerin (OPG), and receptor activator nuclear kappa B ligand (RANKL) were measured and bone mineral density (BMD) was determined at baseline and first, second, third and sixth months.
Results
The study group had higher serum OPG/RANKL ratio and lower ucOC levels compared to the control group at the first month; PICP levels were higher in the study group at second and third months.
Conclusions
These results suggest an early beneficial effect of the combination of vitamin K2 and vitamin D3 on BMD in ALL patients especially during the period of intensive steroid therapy in the first months.
Publisher
Walter de Gruyter GmbH
Subject
Endocrinology,Endocrinology, Diabetes and Metabolism,Pediatrics, Perinatology and Child Health
Reference34 articles.
1. Arceci, RJHI, Smith, OP. Pediatric hematology, 3th ed. Malden: Massechusetts Blackwell; 2006:450–81 pp. 2. Pui, C-H, Evans, WE. Treatment of acute lymphoblastic leukemia. N Engl J Med 2006;354:166–78. https://doi.org/10.1056/nejmra052603. 3. Pui, C-H, Campana, D, Pei, D, Bowman, WP, Sandlund, JT, Kaste, SC, et al.. Treating childhood acute lymphoblastic leukemia without cranial irradiation. N Engl J Med 2009;360:2730–41. https://doi.org/10.1056/nejmoa0900386. 4. Brenner, H, Kaatsch, P, Burkhardt-Hammer, T, Harms, DO, Schrappe, M, Michaelis, J. Long-term survival of children with leukemia achieved by the end of the second millennium. Cancer 2001;92:1977–83. https://doi.org/10.1002/1097-0142(20011001)92:7<1977::aid-cncr1717>3.0.co;2-w. 5. Sala, A, Barr, RD. Osteopenia and cancer in children and adolescents: the fragility of success. Cancer 2007;109:1420–31. https://doi.org/10.1002/cncr.22546.
Cited by
5 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献
|
|