Longitudinal changes in bone mineral density, bone turnover markers, and body composition in children and adolescents treated for acute lymphoblastic leukemia.

Authors

Alessandro Cattoni, Silvia Molinari, Giulia Capitoli, Silvia Vai, Silvia Carrara, Emanuela Galliera, Luca Massaccesi, Maria Laura Nicolosi, Silvia Radaelli, Martina Sarra, Daniele Tondelli, Rocco Corso, Giovanni Speziali, Andrea Biondi, Adriana Balduzzi, Sabrina Corbetta, Alessandra Sala

Published in

Frontiers in endocrinology. Volume 17. Pages 1901073. Epub Oct 19, 2026.

Abstract

Impaired bone mineral density (BMD) is a common finding in young patients with acute lymphoblastic leukemia (ALL). Nevertheless, longitudinal trendlines of BMD and the impact of body composition (BC) on bone health still need to be explored among pediatric survivors. The objective of the study is to report longitudinal changes in BMD and BC in pediatric patients.
This prospective, longitudinal study, collecting BMD and BC (assessed by dual-energy X-ray absorptiometry [DXA]) and circulating bone turnover markers every 6 months for 3 years, from diagnosis of ALL (T₀) until 1 year after the end of antiblastic treatment (T₆).
Forty-nine patients were enrolled. At T₀, lumbar spine (LS-)BMD Z-score was ≤-2.0 in 71.7% of patients [median: -2.8 (-3.5, -1.9)], possibly reflecting trabecular bone infiltration by lymphoblasts. Conversely, total body less than head (TBLH)-BMD Z-score was >-2.0 in 97.8% of patients at T₀ but abruptly declined after 6 months (p < 0.001). Despite a recovery trend after the end of treatment, LS or TBLH-BMD Z-scores were still <-2.0 in 67.7% of the 31 patients still enrolled at T₆. Bone turnover was increased between T₁ and T₄. Lean mass decreased over time, while fat mass progressively increased. Multivariable analysis showed a statistically significant association between appendicular lean mass longitudinal recovery over time and T₁-T₆ TBLH-BMD trendlines (p = 0.008).
In pediatric patients, LS-BMD is remarkably affected at diagnosis of ALL. TBLH-BMD, normal at diagnosis, promptly declines during treatment and baseline values are not retrieved after 36 months. Lean mass is positively associated with longitudinal improvements of subtotal BMD over time.

PMID:
42973471
Bibliographic data and abstract were imported from PubMed on 03 Nov 2026.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.