Absence of prognostic significance of skeletal involvement in acute lymphocytic leukemia and non-Hodgkin lymphoma in children

Appell, Rainer G.; Bühler, T.; Willich, E.; Brandeis, W. E.

doi:10.1007/bf02388765

Cited by 10 publications

(4 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…A recent study found that children with severe skeletal involvement had a better prognosis than children without skeletal involvement [43]. This is in opposition to previous investigators, who had found that skeletal involvement connoted a poorer prognosis [44,45] or no prognostic significance [46][47][48].…”

Section: X-raysmentioning

confidence: 73%

Osteoporosis in Survivors of Acute Lymphoblastic Leukemia

2001

View full text Add to dashboard Cite

Osteoporosis is currently receiving increasing attention as an important late effect in survivors of childhood cancer and its treatment because of their quality of life and its negative effect on the survivors' ability to perform developmentally appropriate activities. Survivors of childhood cancer are especially vulnerable because they are affected during childhood and adolescence, a time when peak bone mass should be achieved. This paper reviews decreased bone density in acute lymphoblastic leukemia (ALL), which is the most common childhood cancer and has a cure rate approaching 80%. Osteopenia/osteoporosis has been observed in all phases of the disease: at diagnosis, during treatment, and throughout the post-treatment period for as long as 20 years. Among the findings that have been described are musculoskeletal pain, disturbed gait, fractures, kyphosis, lordosis, and growth failure. Risk factors not specifically related to ALL include smoking, ingestion of carbonated beverages, and family history of "brittle bone" or fractures. Patients should be counseled in regard to diet, exercise, smoking cessation, and avoidance of carbonated beverages. There are a number of options for specific drug therapy; however, the administration of bisphosponates to children and adolescents must be approached with caution. Research is needed to determine how extensive the problem is and how to best prevent and treat the osteopenia/osteoporosis associated with ALL.

show abstract

Section: X-raysmentioning

confidence: 73%

Osteoporosis in Survivors of Acute Lymphoblastic Leukemia

2001

View full text Add to dashboard Cite

show abstract

“…Complete remission of ALL was induced in all patients, and symptoms of vertebral compression fractures abated following antileukemia therapy. Appell RG et al however did not fi nd any prognostic signifi cance of skeletal involvement in their study of 88 patients of pediatric ALL and NHL [8]. In contrast, G Masera et al reported that children with multiple bone lesions are associated with poor prognosis [9].…”

Section: Discussionmentioning

confidence: 91%

An unusual presentation of pediatric acute lymphoblastic leukemia

Sadawaite

Jijina

Nair

et al. 2008

Indian J Hematol Blood Transfus

View full text Add to dashboard Cite

Acute lymphoblastic leukemia (ALL) is one of the most common hematological malignancies occurring in children. We report an interesting case of ALL with an unusual presentation. This 3-year-old boy came with a 6 month history of multiple pathological fractures, generalized osteopenia and vertebral compression. All the possible causes responsible for this condition were ruled out. His complete blood count which was normal initially evolved into cytopenias. His physical examination revealed generalized lymphadenopathy and hepatosplenomegaly. The complete blood count showed pancytopenia with blasts in peripheral smear. Bone marrow aspirate was suggestive of B ALL. Pediatric ALL patients usually present with symptoms due to cytopenias, fever and bone pains. Although asymptomatic skeletal involvement may be seen in 40-60% of patients at presentation, pathological fractures and vertebral compressions are very rare. Therefore a high index of suspicion is needed to diagnose such cases. Moreover, these patients are usually associated with good prognostic features.

show abstract

“…Ayrıca bu hastaların %41-70'inde tanı anında radyolojik deği-şiklikler görülmektedir. Osteolitik lezyonlar %11-90 oranında, metafizeal bandlar %7-88 oranında, periost reaksiyonu %2-50, diffüz osteoporoz %16-41 ve osteoskleroz %3-31 oranında bildirilmiştir (6) . Makalemizde septik artrit tablosu ile başvuran ve takibinde periost reaksiyonu görülerek ALL tanısı konulan olgu sunulmuştur.…”

Section: Introductionunclassified