Changes in bone metabolic parameters in children with chronic myeloid leukemia on imatinib treatment.
Changes in bone metabolic parameters in children with chronic myeloid leukemia on imatinib treatment.
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DOI：
10.12659/msm.883599
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发表时间：
2012-12
期刊：
影响因子：
--
通讯作者：
Suttorp M
中科院分区：
文献类型：
--
作者：
Jaeger BA;Tauer JT;Ulmer A;Kuhlisch E;Roth HJ;Suttorp M
伊马替尼是慢性粒细胞白血病（CML）前期治疗的高效药物。据报道，在儿童中，纵向生长受损是该药物在长期治疗下产生的副作用。因此，我们前瞻性评估了持续暴露于伊马替尼的 CML 儿科患者骨生化标志物的变化。在 17 例患有骨关节炎的患者中测定了骨代谢标志物（钙、磷酸盐、镁、甲状旁腺激素、维生素 D、l N 型前胶原前肽 [PINP] 和胶原 C 末端交联端肽 [CTX-I]、骨钙素 [OC]、吡啶啉 [PYD] 和脱氧吡啶啉 [DPD]）。 4-17 岁的 CML，在 2.5 年的时间内接受伊马替尼治疗，间隔三个月。 8/17 名患者出现甲状旁腺功能亢进，15/17 名患者发现 25-羟基维生素-D3 水平较低。在 58% 的所有样本中检测到 OC 水平增加，显示每周每升 -0.30 μg OC 线性显着下降 (p=0.04)。在完全来自青春期前患者的样本中，25% 的血清 PINP 降低，57% 的血清 CTX-I 高于正常范围。在所有收集的样本中，尿液 PYD 和尿液 DPD 水平分别高于正常范围 10% 和 9%，并且计算出统计上显着的线性下降 -0.16 nmol DPD/mg 肌酐/周 (p=0.01)。伊马替尼可能会失调骨重塑。数据表明，骨形成受损的程度超过了骨吸收减少的程度。有必要定期评估儿童 CML 长期伊马替尼治疗期间的骨骼活动。
Imatinib is a highly effective drug in up-front treatment of chronic myeloid leukemia (CML). In children impaired longitudinal growth has been reported as side effect exerted by this drug under prolonged therapy. We therefore prospectively evaluated alterations of bone biochemical markers in pediatric patients with CML under ongoing imatinib exposure. Bone metabolic markers (calcium, phosphate, magnesium, parathyroid hormone, vitamin D, procollagen type l N propeptide [PINP], and C-terminal cross-linking telopeptide of collagen [CTX-I], osteocalcin [OC]; pyridinoline [PYD], and desoxypyridinoline [DPD]) were determined in 17 patients with CML aged 4–17 years under imatinib treatment in three-month intervals over a 2.5 year period. Hyperparathyroidism developed in 8/17 patients and low 25-hydroxyvitamin-D3 levels were found in 15/17 patients. Increased OC levels were detected in 58% of all specimen showing a linear significant decline of −0.30 μg OC per l per week (p=0.04). Serum PINP was lowered in 25% and serum CTX-I was above the normal range in 57% of the specimen originating exclusively from prepupertal patients. Urine PYD and Urine DPD levels were above the normal range in 10% and 9%, respectively, of all specimen collected and a statistically significant linear decline of −0.16 nmol DPD/mg creatinine/week was calculated (p=0.01). Bone remodeling may be dysregulated by imatinib. Data suggest that impaired bone formation exceeds that of decreased bone resorption. Regular evaluation of the skeletal actions during long-term imatinib treatment in childhood CML is warranted.
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影响因子：
0.4
作者：
Reiss, I;Inderrieden, D;Kruse, K
通讯作者：
Kruse, K
影响因子：
158.5
作者：
Druker, Brian J.;Guilhot, Francois;Larson, Richard A.
通讯作者：
Larson, Richard A.
影响因子：
5.8
作者：
El-Hajj Fuleihan, G;Klerman, EB;Czeisler, CA
通讯作者：
Czeisler, CA
影响因子：
11.4
作者：
Millot, F;Guilhot, J;Suttorp, M
通讯作者：
Suttorp, M
DOI：
10.1055/s-0029-1211269
发表时间：
1994-01-01
期刊：
EXPERIMENTAL AND CLINICAL ENDOCRINOLOGY
影响因子：
--
作者：
RAUCH, F;SCHONAU, E;SEIBEL, M
通讯作者：
SEIBEL, M