Significance of a comprehensive assessment of risk factors for bone mineral density decrease in the development of secondary osteoporosis

Abstract

Osteoporosis in young people, whether primary or secondary, is a serious and pressing issue in clinical practice. Primary osteoporosis, which is relatively rare, is caused by genetic disorders, congenital anomalies, or disturbances in bone metabolism. A significantly more common secondary osteoporosis develops as a result of a long-term course of various chronic diseases or a complication of their treatment. Key factors triggering secondary osteoporosis include endocrine disorders; syndromes associated with delayed puberty; and prolonged treatment with glucocorticoid hormones and cytostatic drugs. Furthermore, the risk is increased by clinical conditions associated with prolonged immobilization, insufficient or inadequate nutrition, low body weight, and high levels of inflammatory cytokines. It is important that most patients with acute leukemia have nonspecific risk factors for decreased bone mineral density at the time of diagnosis. The presented clinical case highlights the critical importance of a comprehensive assessment of all associated risks when administering high-dose chemotherapy to such patients.