Prospective analysis of bone changes in treated childhood leukemia

Serial knee radiographs were obtained from 58 children with leukemia. Leukemic bone changes were found in approximately half of those radiographed at the time of diagnosis but were consistently absent in children older than 10 years. The bone abnormalities persisted for as long as 10 months after treatment was started and did not occur or reappear at the time of relapse. Dense metaphyses simulating the appearance of lead poisoning developed in 20 of 58 patients during chemotherapy.