Clinical Manifestation of Childhood Acute Leukemia with Bone Involvement |
Kyoung Eun Jeong1, Hee Jung Lee2, Kwang Soon Song3, Heung Sik Kim1, Chin Moo Kang1 |
1Department of Pediatrics, Keimyung University, School of Medicine, Taegu, Korea 2Department of Radiology, College of Medicine, Soonchunhyang University, Seoul, Korea 3Department of Orthopedics, Keimyung University, School of Medicine, Taegu, Korea |
골 침범이 동반된 소아 급성 백혈병의 임상양상 |
정경은1, 이희정2, 송광순3, 김흥식1, 강진무1 |
1계명대학교 의과대학 소아과학교실 2계명대학교 의과대학 진단방사선과학교실 3계명대학교 의과대학 정형외과학교실 |
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Abstract |
Purpose : Bone involvement is known to develop in 40-70% of pediatric acute leukemia. We aimed to analyze the clinical course and result of therapy in pediatric acute leukemia with bone involvement.
Methods : Twenty-seven patients diagnosed as pediatric acute leukemia at Dong San Medical Center from Jan. 1996 to Aug. 1998 were evaluated. According to bone X-ray and whole body bone scan, the patients were divided into two groups.
Results : Twenty-seven patients were enrolled in this study with 14 patients(52%) showing definite bone involvement on simple X-ray or bone scan. Mean age of patients with bone involvement was 5.5 years. Regarding the type of leukemia, 9 patients(64%) were acute lymphocytic leukemia. Ten patients(71%) out of 14 with bone involvement complained of bone pain at the involved bony site. Site of involvement was most frequent in the lower extremity. On simple X-ray, osteolytic lesion was found in 7 patients(50%), diffuse osteopenia in 2 patients(14%) and pathologic fracture in 2 patients(14%). In bone scan, radioactivity was increased in whole cases of patients with bone involvement. Thirteen patients(93%) were completely remitted by chemotherapy, but, one AML patient died due to induction failure.
Conclusion : Bone involvement occured in 52% of pediatric acute leukemia. Bone involvement was more frequent in male patients in the lower extremity, and osteolytic lesion was the most frequent finding on simple X-ray. There was no relevence between bone involvement and prognosis. Further study will be needed to evaluate long-term survival and prognosis. |
Key Words:
Bone involvement, Pediatric acute leukemia |
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