Bone mineral density in children with acute lymphoblastic leukaemia

Bone mineral density (BMD) may be negatively affected by the disease or its treatment in patients with acute lymphoblastic leukaemia (ALL). Therefore, we evaluated lumbar spine and total body BMD and bone metabolism in childr en with ALL at diagnosis, during treatment with chemotherapy and 1 year aft er completion of treatment. 32 children (21 boys and 11 girls) participated in the study. 14 children started the study at diagnosis and 18 during or after the treatment period. Lumbar spine and total body BMD were measured w ith dual energy X-ray absorptiometry, and expressed as standard deviation s cores (SDS). Blood samples were obtained to assess bone metabolism. 3 of 14 children had low lumbar spine BMD (< -2 S.D.) at diagnosis. All children h ad normal total body BMD. Markers of bone turnover were depressed. Total bo dy BMD SDS decreased significantly during the first year of treatment (P<0. 001). Lumbar spine BMD SDS did not change significantly. Parameters of bone turnover increased to normal during the treatment period. Parathyroid horm one had increased significantly after 1 year (P<0.05). Mineral homeostasis was disturbed in some patients during treatment. 4 of 9 patients had low to tal body BMD and 1 patient low lumbar spine BMD one year after completion o f treatment. All patients had normal biochemical results at that time. In c onclusion, lumbar spine BMD and bone turnover were decreased in some patien ts at diagnosis. Total body BMD decreased significantly during treatment an d was low in 4 of the 9 patients 1 year after completion of the treatment. (C) 1999 Elsevier Science Ltd. All rights reserved.