No impact of disease and its treatment on bone mineral density in survivors of childhood acute lymphoblastic leukemia

Background Acute lymphoblastic leukemia (ALL) and its treatment are often implicated in adversely affecting bone health. Conflicting reports in the literature and a paucity of studies from the developing world prompted us to study bone mineral density (BMD) in childhood ALL survivors. Methods BMD lumbar spine (LS) and whole body (WB) were evaluated, using dual energy x‐ray absorptiometry in 65 pediatric ALL survivors who had been off‐therapy for at least 2 years. The control group constituted of 50 age‐ and sex‐matched healthy siblings. Kernel density plots were used to compare BMD among cases and controls. The disease‐, treatment‐, hormone‐ and lifestyle‐related factors likely to modulate BMD were analyzed using the Mann–Whitney U test and Student's t‐test. Results At a median of 4.3 years (range, 2–14.8 years) since cessation of therapy, height‐adjusted (HA) mean BMD Z‐scores of LS (−0.67 ± 1.11, −0.607 ± 1.05, P = 0.759) and WB (−0.842 ± 0.92, −0.513 ± 0.97, P = 0.627) were comparable among the cases and controls. Disease, treatment (chemotherapy, cranial radiotherapy) and endocrine factors did not predict low BMD. However, survivors with calcium intake