Objective: Assessment of low bone mass in children with acute lymphoblastic leukemia.
Methods: A total of 141 patients (83 boys and 57 girls) treated for acute lymphoblastic leukemia at the Department of Pediatric Hematology and Oncology of Medical University of Bialystok in Poland were assessed for low bone mineral density. Depending on age of diagnosis three clinical groups were analyzed: i) up to 5 years old, ii) from 6 to 12 years old, and iii) from 13 to 18 years old. Survival was measured as the date of birth to the date of low bone mass at DXA scans or most recent follow-up. Statistical analysis was performed using KaplanMeier Method, Wilcoxons test and χ2 test. A P value <0.05 was considered significant.
Results: Median age at diagnosis was 5.9 years (3.8, 9.5). The longest observation period was 20.9, while medium time for a whole group was 17.97 years. There was no statistical difference in time to low bone mass between males and females (P=0.218). However, the number of observed events of low bone mass in boys was lower than expected. Patients diagnosed between 6 and 12 years of age tended to have bone deficits earlier then patients diagnosed before 5 and after 13 year of life (P=0.068). Among all patients a low bone mass (defined as a Z-score ≤−2) was observed in a total of 17/83 boys and 20/57 girls (P=0.054).
Conclusion: This study suggests that there is no difference in time of occurrence of low bone mass between the analyzed groups. However 20.5% of boys and 35% of girls had a low bone mass during the study. It seems that children diagnosed with acute lymphoblastic leukemia should be screened for bone mass.
22 Jun 2013 - 25 Jun 2013