With increased survival of children with cancer, research into both acute side effects and long-term side effects has become increasingly important to also improve the quality of life of survivors. Bone toxicity (brittle bones), frailty and sarcopenia (muscle weakness) are side effects of pediatric cancer treatment with a significant disease burden and mortality.
Brittle bones
Jenneke van Atteveld, physician-researcher at the Princess Máxima Center, says: ‘Most of the studies in my dissertation were performed in survivors at the LATER clinic. We knew that brittle bones were common in this group, but we didn't really know who to screen for this. And, we did not know with what type of treatment or other factors brittle bones, frailty and sarcopenia could be associated. We were able to determine for the first time that survivors of childhood cancer actually break their bones more often compared to healthy people, and that they seem to get 'old' sooner.
Risk factors
'Through my research, we are able to better identify individuals at high risk for bone toxicity,' the PhD-student explains. 'We have also identified novel risk factors for bone toxicity, frailty and sarcopenia in pediatric cancer survivors, such as certain hormone and vitamin deficiencies. This is important to potentially prevent these harmful side effects over time.’
New international guideline
Jenneke: 'Specifically, the guideline for bone mineral density surveillance is now in use. We recommend measuring bone mineral density in all high-risk survivors (treated with cranial radiotherapy, total body radiotherapy and some patients who have had steroids), namely five years after therapy and at the age of 25. This will allow earlier detection and treatment of low bone mineral density.' It is an important step towards improving bone strength and preventing fractures resulting from treatment for childhood cancer.
Coordinate
On her PhD project in the Van den Heuvel-Eibrink group, Jenneke van Atteveld looks back with pleasure: 'I worked on this subject with interest for over four years. Bone toxicity in the context of childhood cancer has long been a line of research in our group, and I was able to take that a step further. One of the best parts of my PhD program was coordinating the treatment guideline with 36 experts from 10 countries. I also had the honor to present my research at many (inter)national conferences. I like the fact that my research has come to attention in this way, and hope it will help spread the research findings.’