SEVERE OSTEOPOROSIS AND MULTIPLE VERTEBRAL COLLAPSES IN A CHILD DURING TREATMENT FOR B-ALL

The incidence of bone lesions at diagnosis of childhood acute lymphobl astic leukemia (ALL) is relatively high. However, no cases of severe o steoporosis with multiple vertebral collapses secondary to treatment i n children with ALL have been reported. We report the case of a 9-year -old-boy with B-ALL, with no bone lesions at the diagnosis that, follo wing the 4th block of aggressive chemotherapy (protocol B-ALL BFM 86), presented severe back pain and functional impairment with diffuse ost eoporosis and vertebral collapses. He was treated with calcitonin, vit amin D, calcium, physical therapy and orthopedic corset. Osteoporosis progressed slowly during the following 2 months of chemotherapy and th e boy developed dorsal kyphosis. After discontinuing antiblastic treat ment progressive clinical improvement was observed, with complete reso lution of kyphosis in about 6 months. An almost complete bone recovery was seen on X-ray survey at 26-months follow-up.