[Skeletal changes in children with acute lymphoblastic leukemia]

Children with acute lymphoblastic leukemia frequently show skeletal changes. We examined 50 children with acute lymphoblastic leukemia with reference for skeletal pain as well as the nature and the degree of skeletal changes. 14 children had bone pain. The pain did not correlate with the roentgenographic findings. Some children had characteristic bone changes without bone pain. Roentgenographic findings were observed in 35 of the 50 children (70%). The major lesions observed were: transverse metaphyseal lucent bands, osteolytic lesions, osteosclerotic lesions, periosteal reaction and osteoporosis. Different pathologic findings in leukemia have been given a prognostic value. This was also done for the bony changes but the literature is not coherent on this point. In the group of 17 children with evident skeletal changes, 15 had a non B- non T-cell leukemia. Also the age of the patient, apart from the immunological cell type, seems to be an important factor in the incidence of initial skeletal roentgenographic findings.