标准 CHOP 治疗包括高累积剂量的泼尼松，研究表明 CHOP 后骨折风险增加。目前尚不清楚骨矿物质密度（BMD）的降低是由糖皮质激素引起还是与化疗联合引起。我们的目的是确定 obinutuzumab (G)/利妥昔单抗 (R)-苯达莫司汀与 G/R-CHOP 对滤泡性淋巴瘤患者 BMD 的影响。这项 GALLIUM 事后研究中的患者年龄≥60岁，在接受 G 或 R 联合苯达莫司汀或 CHOP 治疗后，诱导治疗完成 (ITC) 时已完全缓解。为了评估 BMD，每年在计算机断层扫描中测量腰椎 L1 的亨斯菲尔德单位 (HU)。此外，还记录了椎骨压缩性骨折。在 173 名患者中，59 名 (34%) 接受了 CHOP，114 名 (66%) 接受了苯达莫司汀。基线时，各组之间的 HU 没有差异。 CHOP 后从基线到 ITC 的平均 HU 降低为 27.8，苯达莫司汀后为 17.3，相当于 10.4 的差异（95% CI：3.2-17.6）。接受 CHOP 治疗的患者有 5/59 例，接受苯达莫司汀治疗的患者有 2/114 例发生椎骨骨折。 CHOP 与 BMD 显着下降和更频繁的骨折有关。这些结果表明应考虑预防 BMD 损失。© 2023 作者。英国血液学杂志由英国血液学会和约翰·威利出版

Standard CHOP treatment includes a high cumulative dose of prednisone, and studies have shown increased fracture risk following CHOP. It is unclear whether reductions in bone mineral density (BMD) are caused by glucocorticoids or by the combination with chemotherapy. Our objective was to determine the effect of obinutuzumab (G)/rituximab (R)-bendamustine versus G/R-CHOP on BMD in follicular lymphoma patients. Patients in this GALLIUM post hoc study were ≥60 years old and in complete remission at induction treatment completion (ITC), following treatment with G or R in combination with bendamustine or CHOP. To assess BMD, Hounsfield units (HU) were measured in lumbar vertebra L1 on annual computed tomography. Furthermore, vertebral compression fractures were recorded. Of 173 patients included, 59 (34%) received CHOP and 114 (66%) received bendamustine. At baseline, there was no difference in HU between groups. The mean HU decrease from baseline to ITC was 27.8 after CHOP and 17.3 after bendamustine, corresponding to a difference of 10.4 (95% CI: 3.2-17.6). Vertebral fractures were recorded in 5/59 patients receiving CHOP and in 2/114 receiving bendamustine. CHOP was associated with a significant greater decrease in BMD and more frequent fractures. These results suggest that prophylaxis against BMD loss should be considered.© 2023 The Authors. British Journal of Haematology published by British Society for Haematology and John Wiley & Sons Ltd.