Back pain and vertebral compression: an uncommon presentation of childhood acute lymphoblastic leukemia

Acute lymphoblastic leukemia (ALL) presenting with bone pain and leukopenia is a recognized clinicopathological complex. Three patients with ALL presented with back pain as the major symptom. These cases, together with those previously described in the literature, illustrate that delay in diagnosis frequently occurs, with the classic features of the disease being uniformly absent. The reasons for the etiology of the bone pain in ALL are in dispute. It would appear, however, that if early diagnosis can be made, then prognosis is not impaired.