Major bone lesions in acute lymphoblastic leukaemia

Hughes, Richard G.M.; Kay, H. E. M.

doi:10.1002/mpo.2950100111

Cited by 25 publications

(4 citation statements)

References 5 publications

(3 reference statements)

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“…Bone pains, joint pains and swelling are common presenting features of lymphoblastic leukaemia and skeletal radiographs (rarely clinically indicated) show lytic lesions, periosteal reactions or metaphyseal changes in many children with ALL. Such patients frequently have low leucocyte counts and the diagnosis of leukaemia may not be apparent on the blood film (Hughes & Kay, 1982). A common diagnostic error, fortunately now rare, was to diagnose children with such symptoms as having juvenile rheumatoid arthritis, treat them with steroids and only recognize leukaemia after relapse of a steroid‐induced remission.…”

Section: Systemic Disease and Infectionsmentioning

confidence: 99%

Pitfalls in the diagnosis of childhood leukaemia

Chessells

2001

Br J Haematol

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Section: Systemic Disease and Infectionsmentioning

confidence: 99%

Pitfalls in the diagnosis of childhood leukaemia

Chessells

2001

Br J Haematol

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“…Osteolytic lesions, juxtametaphyseal lucent bands and periosteal bone formation arc relatively frequent (about 10%) in children with acute lymphoblastic leukemia (ALL) at diagnosis [1][2][3]. Diffuse osteoporosis and verte bral fractures are present in about 1% of the cases [4][5][6][7], These lesions can be secondary to the disease which may cause an alteration of bone mineral metabolism [8][9][10].…”

Section: Introductionmentioning

confidence: 99%

Severe Osteoporosis and Multiple Vertebral Collapses in a Child during Treatment for B-ALL

et al. 1993

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The incidence of bone lesions at diagnosis of childhood acute lymphoblastic leukemia (ALL) is relatively high. However, no cases of severe osteoporosis with multiple vertebral collapses secondary to treatment in children with ALL have been reported. We report the case of a 9-year-old-boy with B-ALL, with no bone lesions at the diagnosis that, following the 4th block of aggressive chemotherapy (protocol B-ALL BFM 86), presented severe back pain and functional impairment with diffuse osteoporosis and vertebral collapses. He was treated with calcitonin, vitamin D, calcium, physical therapy and orthopedic corset. Osteoporosis progressed slowly during the following 2 months of chemotherapy and the boy developed dorsal kyphosis. After discontinuing anti-blastic treatment progressive clinical improvement was observed, with complete resolution of kyphosis in about 6 months. An almost complete bone recovery was seen on X-ray survey at 26-months follow-up.

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“…The prognosis of survival outcomes of MSK involvement in childhood leukemia is controversial. Some studies have reported that children with MSK involvement had better survival outcomes than those without MSK involvement [ 14 , 32 – 34 ], while many found no difference in survival outcomes [ 8 , 13 , 15 , 17 , 29 , 35 , 36 ] and one study reported a poor prognosis in patients with severe bone involvement [ 37 ]. Our study, using a propensity score-matching method for balancing risks between the study groups, found that the presence of MSK involvement did not have a significant association with prognosis in childhood leukemia.…”

Section: Discussionmentioning

confidence: 99%

Musculoskeletal involvement in childhood leukemia: Characteristics and survival outcomes

et al. 2022

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Background Childhood leukemia with musculoskeletal (MSK) involvement mimics various conditions, which consequently leads to diagnostic delays. The clinical implication of MSK involvement in this disease on survival outcomes is inconclusive. This study aimed to compare characteristics and survival outcomes between MSK and non-MSK involvement in childhood leukemia. Methods The medical records of children newly diagnosed with acute leukemia of an age under 15 years were retrospectively reviewed. Two-to-one nearest-neighbor propensity score-matching was performed to obtain matched groups with and without MSK involvement. The Kaplan–Meier method and log-rank test were then used to assess the effect of MSK involvement on survival outcomes. Results Of 1042 childhood leukemia cases, 81 (7.8%) children had MSK involvement at initial presentation. MSK involvement was more likely in children with acute lymphoblastic leukemia than acute myeloid leukemia (p < 0.05). Hematologic abnormalities were less frequent in the MSK involvement group (p < 0.05). The absence of peripheral blast cells was significantly higher in the MSK involvement group (17.3% vs 9.6%, p = 0.04). Normal complete blood counts with absence of peripheral blast cells were found 2.5% of the children with MSK involvement. By propensity score-matching for comparable risk groups of children with and without MSK involvement, the 5-year overall survival was not significantly different (48.2% vs 57.4%, respectively, p = 0.22), nor was event-free survival (43.3% vs 51.8%, respectively, p = 0.31). Conclusion Childhood leukemia with MSK involvement had the characteristics of minimal or absent hematologic abnormalities and peripheral blast counts.

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Major bone lesions in acute lymphoblastic leukaemia

Cited by 25 publications

References 5 publications

Pitfalls in the diagnosis of childhood leukaemia

Pitfalls in the diagnosis of childhood leukaemia

Severe Osteoporosis and Multiple Vertebral Collapses in a Child during Treatment for B-ALL

Musculoskeletal involvement in childhood leukemia: Characteristics and survival outcomes

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