ESPE Abstracts

Objective: To determine the periodic outcomes of systemic steroid use in ALL treatment and to develop preventive and early treatment approaches for osteoporosis.

Materials and Methods: Our study group consisted of 34 patients who are under follow-up and treatment for ALL at our hospital. Patients receiving BFM ALL IC 2009 chemotherapy (CT) protocol and who completed the first 33 days of corticosteroid treatment (induction CT) were included in the study. Based on the diagnosis date, they were divided into 5 groups according to CT periods. The patients' epidemiological characteristics, hematological findings, biochemical values, vitamin D levels, and bone density measured by DXA method were evaluated. Z-score values between -1 and -2 were defined as osteopenia, and those below -2 were defined as osteoporosis.

Results: In our study, it was found that female gender, advanced Tanner stage, and body mass index (BMI) were positively correlated with bone density and statistically significant. Other biochemical findings and clinical symptoms were not statistically significant. The group of patients who completed their treatment and were on follow-up had the highest BMD Z scores, while the group covering the period 12-18 months after intensive glucocorticoid treatment had the lowest BMD Z scores.

Conclusion: Regular DEXA measurements from the 6th month of ALL treatment will be guiding to prevent future osteoporosis, osteonecrosis, and fractures, by directing patients to exercise and starting vitamin D prophylaxis.

Keywords: Acute lymphoblastic leukemia, Corticosteroid, Osteoporosis