RADIOGRAPHIC FINDINGS IN CHILDHOOD LYMPHOBLASTIC LEUKEMIA BEFORE AND AFTER CHEMOTHERAPY

This study was performed to determine the frequency and degree of osteopenia and other radiographic abnormalities in children with acute lymphoblastic leukemia at presentation and after completion of chemotherapy. For this purpose, in this prospective investigation, patients, aged one to ten years, with acute lymphoblastic leukemia (ALL) were studied by radiographic evaluation of left hand, wrist and forearm at presentation of their disease and three to eight months after completion of induction chemotherapy. This study was conducted in Shiraz University hospitals and two radiologists reviewed the radiographs separately with single blind method. Twenty seven patients (14 boys and 13 girls) were the subjects of this study. The mean age was 4.8  2.4 years. Osteopenia, with varying degrees of severity, was observed in 26-59 % of patients with ALL at presentation of their disease and in 35-80% of them after completion of chemotherapy. Dense methaphyseal band was observed in 7.4 to11.1 % of patients and radiolucent methaphyseal band was observed in 3.7% of patients at presentation. These findings increased to 25-55 % and 5-20 % consecutively after completion of chemotherapy. These results demonstrate that children with ALL are at risk of developing osteopenia especially after chemotherapy. Therefore, it is reasonable to evaluate bone mineral density especially after the completion of chemotherapy to identify patients at risk for osteopenia and appropriate interventions be undertaken to prevent further decrease in their skeletal mass.