Evaluating Bone Mineral Density in Pediatric Acute Lymphoblastic Leukemia Survivors: A Tertiary Care Hospital Experience

Abstract

Acute leukemias are the most common malignancies seen in children and they account for one third of childhood cancers. Children who survived ALL, experience reduced bone mineral density (BMD) due to the disease, long-lasting glucocorticoid usage, chemotherapy toxicities, nutritional deficiencies and physical immobility. The decreased BMD have determined at all stages of disease. This retrospective cross-sectional study purposes to analyse the results of BMD in children who have completed their ALL treatment. Data of 58 pediatric ALL survivors whose z-scores were calculated by DEXA, were reviewed from their medical records. Twenty-one (38%) patients had normal BMD. Low bone mineral density was detected in 29 (50%) and osteoporosis was detected in 8 (12%) patients. There was nostatistically significant difference between BMD and sex, immunophenotype, leukemia risk group or age at diagnosis (p > 0.05). Only, a significant difference was found between BMD and vitamin D supplementation received or not received during chemotherapy (p < 0.05). Also There was no statistically significant difference between mean levels of Ca, P, ALP, vitamin D and result of DEXA (p > 0.05). Children with cancers such as ALL are malnourished and have limited physical activity during under chemotherapy. Nutrition and physical activity supporting a growing healthly bone should be provided for all children with cancer from the start of chemotherapy until bone gowth is complete.