title: Evaluation of bone metabolism in children with acute lymphoblastic leukemia after induction chemotherapy treatment.
abstract: Osteopenia and osteoporosis are currently receiving particular attention as late effects of therapy in survivors of childhood acute lymphoblastic leukemia (ALL). The aim of this study was to evaluate abnormalities in bone mass and mineral homeostasis in children with ALL after induction therapy (during consolidation treatment). Lumbar spine (L2-L4) bone mineral density (BMD, g/cm(2)) was measured by dual energy X-ray absorptiometry in 20 children with ALL, a median of 25.9 months postdiagnosis and results were expressed as z-scores relative to healthy Caucasian children (controls). Serum levels of intact parathyroid hormone (iPTH), alkaline phosphatase (ALP), calcium, phosphate, and magnesium were also analyzed. In addition, the body mass indexes (kg/cm(2)) of patients and controls were calculated. Results were compared with those of 40 healthy controls. Among the 20 children with ALL (12 boys and 8 girls), 12 presented z-scores < 1 SD (normal) and 8 were osteopenic (z-score between 1 and 2.5 SD). In addition, children with ALL had reduced lumbar BMDs (z-score -0.817) in comparison to healthy controls (z-score -0.353) (p = .04). Moreover, alkaline phosphatase and intact parathyroid hormone values were significantly increased compared to controls values. The data demonstrate that bone metabolism in children with ALL during consolidation therapy is disturbed, resulting in a reduced BMD and z-score with respect to healthy controls. Since a reduced BMD predisposes to osteopenia and osteoporosis, specific attention and therapeutic interventions should be considered.
authors: 2nd Pediatric Department Hematology-Oncology Unit, AHEPA Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
authors: Fani
authors: F
authors: Athanassiadou
authors: Athanassios
authors: A
authors: Tragiannidis
authors: Israel
authors: I
authors: Rousso
authors: Georgios
authors: G
authors: Katsos
authors: Vassiliki
authors: V
authors: Sidi
authors: Dimitrios
authors: D
authors: Koliouskas
authors: Cristos
authors: C
authors: Papastergiou
authors: Ioannis
authors: I
authors: Tsituridis
mesh_terms: D015502:Absorptiometry, Photon; D000293:Adolescent; D000970:Antineoplastic Agents / Q000627:therapeutic use; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D015519:Bone Density; D001851:Bone Diseases, Metabolic / Q000175:diagnosis / Q000209:etiology*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae / Q000503:physiopathology; D008297:Male; D010024:Osteoporosis / Q000175:diagnosis / Q000209:etiology; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications* / Q000188:drug therapy; D011446:Prospective Studies; D012074:Remission Induction
chemical_list: D000970:Antineoplastic Agents; D015415:Biomarkers