All issues > Volume 43(6); 2000

Original Article

J Korean Pediatr Soc. 2000;43(6):806-813. Published online June 15, 2000.

Clinical Manifestation of Childhood Acute Leukemia with Bone Involvement

Kyoung Eun KE Jeong¹, Hee Jung HJ Lee², Kwang Soon KS Song³, Heung Sik HS Kim¹, Chin Moo CM 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

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.

Keywords :Bone involvement, Pediatric acute leukemia