Assessment of Bone Mineral Density in Pediatric Patients With Acute Leukemia

TL;DR

This study found that many children with acute leukemia undergoing chemotherapy have reduced bone mineral density, highlighting the need for bone health monitoring and early intervention.

Contribution

The study provides new insights into the prevalence of osteopenia and osteoporosis in pediatric leukemia patients during chemotherapy.

Findings

46.43% of patients had osteopenia and 28.57% had osteoporosis based on DEXA scans.

Vitamin D deficiency was observed in 95.31% of patients.

Low serum albumin and deficiencies in folate and vitamin B12 were also common.

Abstract

Background

Acute lymphoblastic leukemia (ALL) is the most prevalent highly curable childhood cancer, with long-term survival rates exceeding those of most other cancers. However, concerns persist regarding the adverse effects of treatment, particularly on bone health. Children with ALL often experience complications such as impaired growth, bone loss, and endocrine irregularities. This study aims to assess bone mineral density (BMD) in pediatric ALL patients undergoing chemotherapy, shedding light on the overlooked issue of osteoporosis.

Methodology

A prospective, observational study was conducted from February 2018 to August 2019. Children and adolescents (aged 2-20 years) with ALL or acute myelogenous leukemia undergoing induction chemotherapy were included. Baseline characteristics, nutritional parameters, and biochemical data were collected. BMD was assessed using dual-energy X-ray absorptiometry (DEXA).

Results

Among 64 patients, the majority were males (67.18%), and 39.06% were aged 16-20 years. Low serum albumin levels (20.31%) and deficiencies in folate (25.00%), vitamin B12 (28.13%), and vitamin D (95.31%) were observed. DEXA scans revealed that 46.43% had osteopenia, 28.57% had osteoporosis, and 25% had normal BMD. Serum calcium and vitamin D levels fluctuated but were not statistically significant. Duration from diagnosis to treatment did not differ significantly between patients with poor prognosis and those who achieved remission (p = 0.222).

Conclusions

This study underscores the need to monitor bone health in pediatric ALL patients, with a focus on early intervention and specialized care to manage osteopenia and osteoporosis. Comprehensive nutritional and metabolic assessments are essential for their well-being during leukemia treatment.