Evaluation of Bone Mass Density in Children and Adolescents with Acute Lymphoblastic Leukemia

Abstract

Background: Leukemia is a group of blood cancers that usually begin in the bone marrow and result in high numbers of abnormal blood cells. These blood cells are not fully developed and are called blasts or leukaemia cells. Aim of Work: Our study aimed to evaluate bone density by DXA scan in children and adolescents with Acute Lymphoblastic leukaemia at diagnosis and after 6 m of treatment with chemotherapy. Subject and Methods: The study was conducted in the Pediatric Department Hematology and Oncology Unit of Tanta University and Tanta Cancer Center, From November 2020 to November 2022. Study Subjects: Evaluation of Bone Mass Density in Children and Adolescents with Acute Lymphoblastic Leukemia. Study design: observational cross-sectional. This study included 25 children diagnosed with Acute Lymphoblastic Leukemia (the same 25 Patients were examined at diagnosis and after 6 months of treatment with chemotherapy). Results: The mean age of this study children was 7.92+ 3.59 years in group I and 8.42+ 3.59 years in group II. The two groups were matched as regards weight, Height, and BMI. In the present study, Bone Mass Density was significantly lower in the leukaemia children after 6 months of treatment of chemotherapy (0.53±0.11), compared to leukaemia children at the time of diagnosis (0.59±0.11) (P<0.05). Also, bone mineral content and Z score were significantly lower in group II patients (20.5±7.82 and 1.120±0.37, respectively), compared to group I (23.13±9.18 and 2.25±0.45, respectively). Conclusion: Bone Mass Density, bone mineral content and Z score are significantly lowered after chemotherapy of ALL patients. Since a reduced BMD predisposes to osteopenia and osteoporosis, the use of DXA scanning to evaluate and monitor BMD in children with ALL may be useful to identify those patients at risk for developing osteopenia, osteoporosis, and pathological fractures.