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Abstract
A prospective study was conducted to investigate the possibility of osteoporosis after
treatment for childhood acute lymphoblastic leukemia (ALL). Forty-two survivors of
ALL had the trabecular bone density of the spine evaluated by quantitative computed
tomography, 6 to 98 months (mean 42 months) after completion of chemotherapy. The
ALL survivors had significantly lower bone density than age-, gender-, and race-matched
nonleukemic control subjects had (10% less, p less than 0.001); this decrease was
accounted for solely by the subset of patients who had received cranial irradiation
(n = 30; p less than 0.001). The relative reduction in bone density in ALL survivors
was unrelated to age at the time of diagnosis or time without therapy. The effects
on bone density of 18 Gy and of 22.5 to 25.2 Gy were indistinguishable. We conclude
that survivors of ALL commonly have reduced bone density in the lumbar spine and suggest
that the diminution is related to nervous system irradiation, not to the disease or
to chemotherapy.