Reduced bone mineral density in long-term survivors of childhood acute lymphoblastic leukemia

J Pediatr Hematol Oncol. May-Jun 1998;20(3):234-40. doi: 10.1097/00043426-199805000-00009.

Abstract

Purpose: Osteoporosis and pathologic fractures are occasionally found in patients with childhood acute lymphoblastic leukemia (ALL). This study was performed to determine the degree of possible osteopenia in long-term survivors of childhood ALL.

Patients and methods: Lumbar spine (L2-L4) and femoral neck bone mineral densities (BMDs) (g/cm2) were measured in 29 survivors (aged 12 to 30 years, median 17) of childhood ALL 2 to 20 (median 8) years after discontinuation of chemotherapy. These results were compared with those from 273 healthy controls and expressed as a percentage of the age- and sex-matched control values (mean +/- standard deviation).

Results: Lumbar and femoral BMDs were significantly reduced in survivors of childhood ALL. Particularly, male gender (lumbar: 91.7 +/- 10.4%, p = 0.008; femoral: 91.9 +/- 11.3%, p = 0.005) and a history of cranial irradiation (lumbar: 93.0 +/- 8.9%, p = 0.005; femoral: 94.4 +/- 13.3%, p = 0.03) were associated with low lumbar and femoral BMDs.

Conclusions: The detected deficit in bone density in survivors of childhood ALL may predispose these patients to osteoporotic fractures later in adulthood. A follow-up of BMD in survivors of childhood ALL should facilitate the identification of patients who would require specific therapeutic interventions to prevent further decrease of their skeletal mass and preserve their BMD.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Absorptiometry, Photon
  • Adolescent
  • Adult
  • Bone Density*
  • Bone Diseases, Metabolic / complications
  • Bone Diseases, Metabolic / diagnosis*
  • Child
  • Collagen / blood
  • Collagen Type I
  • Cranial Irradiation / adverse effects
  • Female
  • Follow-Up Studies
  • Humans
  • Insulin-Like Growth Factor I / analysis
  • Male
  • Osteocalcin / blood
  • Peptide Fragments / blood
  • Peptides / blood
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / complications
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / physiopathology*
  • Procollagen / blood
  • Sex Factors
  • Survivors

Substances

  • Collagen Type I
  • Peptide Fragments
  • Peptides
  • Procollagen
  • collagen type I trimeric cross-linked peptide
  • procollagen type I carboxy terminal peptide
  • Osteocalcin
  • Insulin-Like Growth Factor I
  • Collagen