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Are Survivors of Childhood Acute Lymphoblastic Leukemia at Increased Risk for Low Bone Mass?

Adriana Aparecida Siviero Miachon, Maria Lucia de Martino Lee, Gil Guerra-Junior and Angela Maria Spinola-Castro1

Acute lymphoblastic leukemia is the most prevalent cancer in children. As an increasing number of cancer survivors reaches adulthood, there may be consequences of the treatment, and there is an issue if low bone mass might be included as a significant late effect. Acute lymphoblastic leukemia patients may have their bone mass compromised during therapy and many years after its withdrawal, but the degree of bone mass decline or recovery are not well elucidated to date. Survivors of stem cell transplantation for leukemia have additional risk factors for bone loss and should be evaluated with caution. Our target is to make a warning about the difficulties in assessing and interpreting bone mass in children and adolescents, the limitations in this assessment in acute lymphoblastic leukemia young survivors (including survivors of stem cell transplantation), the possibility of misdiagnoses, the reasons (if there are any) of low bone mass in this particular group of cancer survivors, as well as consider the therapeutic issues available.