Table 3.
Associations between clinical factors and incident fracture
| Univariate analysis | Multivariate analysis* | |||||
|---|---|---|---|---|---|---|
| Clinical characteristic | Incident fracture (n=16) | No incident fracture (n=146) | OR (95% CI) | p-value | OR (95% CI) | p-value |
| Age in years, mean ± SD | 67 ± 11.4 | 57 ± 15.5 | 1.05 (1.01–1.09) | 0.02 | 1.02 (0.98–1.07) | 0.29 |
| Female, n (%) | 6 (38) | 57 (39) | 1.07 (0.37–3.10) | 0.90 | ||
| BMI (kg/m2), mean ± SD | 26 ± 4.5 | 26 ± 5.6 | 0.97 (0.86–1.10) | 0.65 | ||
| Diagnosis, n (%) | ||||||
| • DLBCL | 13 (81) | 131 (90) | ref. | |||
| • Other | 3 (19) | 15 (10) | 2.02 (0.52–7.89) | 0.31 | ||
| Ann Arbor Stage, n (%) | ||||||
| • Stage I–II | 6 (38) | 69 (47) | ref. | |||
| • Stage III–IV | 10 (63) | 77 (53) | 1.49 (0.52–4.32) | 0.46 | ||
| IPI score, n (%) | ||||||
| • 0–1 (low risk) | 3 (20) | 58 (42) | ref. | |||
| • 2–5 (intermediate to high risk) | 12 (80) | 80 (58) | 2.90 (0.78–10.74) | 0.11 | ||
| LDH, mean ± SD | 378 ± 285 | 384 ± 893 | 1.00 (1.00–1.00) | 0.98 | ||
| Bone marrow involvement, n (%) | 3 (19) | 28 (20) | 0.94 (0.25–3.52) | 0.93 | ||
| Prior diagnosis of osteoporosis, n (%) | 1 (6) | 4 (3) | 2.28 (0.24–21.78) | 0.47 | ||
| Bone active medications, n (%) | ||||||
| • Vitamin D | 3 (19) | 21 (14) | 1.37 (0.36–5.23) | 0.64 | ||
| • Calcium | 2 (13) | 18 (12) | 1.02 (0.21–4.84) | 0.98 | ||
| • Bisphosphonate | 0 (0) | 3 (2) | --† | -- | ||
| Prevalent fracture, n (%) | 12 (75) | 26 (18) | 13.85 (4.14–46.36) | <0.0005 | 10.45 (2.90–37.74) | <0.0005 |
| First-line therapy regimen, n (%) | ||||||
| • R-CHOP | 9 (56) | 88 (60) | ref. | |||
| • R-EPOCH | 6 (38) | 54 (37) | 1.09 (0.37–3.22) | 0.88 | ||
| • Other | 1 (6) | 4 (3) | 2.44 (0.25–24.29) | 0.45 | ||
| Number of cycles, mean ± SD | 5.3 ± 1.3 | 5.8 ± 0.8 | 0.60 (0.38–0.94) | 0.03 | 0.62 (0.37–1.04) | 0.07 |
| Radiation therapy, n (%) | 3 (19) | 22 (15) | 1.29 (0.34–4.90) | 0.71 | ||
| CR after first-line therapy, n (%) | 12 (75) | 129 (88) | 0.40 (0.11–1.37) | 0.14 | ||
OR odds ratio; CI confidence interval; SD standard deviation; BMI body mass index; DLBCL diffuse large B-cell lymphoma; IPI International Prognostic Index; LDH lactate dehydrogenase; R-CHOP rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone; R-EPOCH rituximab, etoposide, prednisone, vincristine, cyclophosphamide, doxorubicin; CR complete remission
*Multivariate logistic regression performed with variables significant at p<0.05 in univariate analysis
†Bisphosphonate use predicted no incident fracture perfectly, so it was dropped from the univariate logistic regression
Statistically significant ORs with p-value <0.05 are italicized for emphasis