Title: Bone turnover in children with acute lymphoblastic leukemia
- K. Muszyńska-Rosłan, Maryna Krawczuk-Rybak, Magdalena Wiśniewska, Edyta Siedlecka, Piotr Protas, Sławomir Wołczyński
- Original articles
- Pediatric Review
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- Final page:
- biochemical markers ofbone turnover, cancer treatment, children
The treatment of acute lymphoblastic leukemia in children consists of steroid-, chemo- and radiotherapy, leading to disturbances in bone turnover and bone mass accumulation. This may be associated with reduced peak bone mass and increased risk ofosteoporosis. The purpose ofthe study was to evaluate the changes in biochemical markers ofbone turnover in children with acute lymphoblastic leukemia at diagnosis, after induction ofremission and after intensive treatment. Methods: Serum levels ofosteocalcin (OST), alkaline phosphatase (BALP) and collagen carboxy terminal telopeptide (ICTP), parathyroidhormone (PTH), vitamin D3 (VIT. D3) were measured to evaluate bone turnover. Results: Means ofOST, BALP and ICTP level after completion of intensive treatment were statistically higher in comparison to that at diagnosis (64. 11±32.07vs. 31.28±25.64 ng/ml; 159.69±82.78 vs. 84.17±2.14U/l; 14.36±6.17vs. 10±4.29ng/l, respectively). Meanvalues ofvit. D3were also higherin 3rdthanin 1st assessment (117.44±81.07 vs. 59.62±30.34) and PTH were lower after treatment than at diagnosis (18.02±1.72 vs. 23.14±12.88). 2. No correlations in mean values of bone turnover markers between the 1st and 2nd, and between the 2nd and 3rd measurements were found. 3. We observed lower values ofOST and ICTP at diagnosis and decreased level ofOST after induction ofremission in comparison to the healthy controls. No difference between OST and ICTP after intensive treatment was found. Conclusions: 1. Decreased levels of biochemical markers ofbone turnover at diagnosis ofALL may point discharges in bone metabolism and may result from neoplastic disease. 2. Normalization of biochemical markers of bone formation and resorption after intensive treatment may suggest active bone remodelling to compensate its disturbances.