Bone Abstracts

Improvements on the overall cure rates for childhood acute lymphoblastic leukemia (ALL) have allowed the cure of over 85% of treated patients. At least 70% of survivors of childhood ALL cancers have substantial morbidities as a result of their treatment. Long term musculoskeletal complications in this population are currently receiving increasing attention because of their negative impact on the quality of life and ability to perform appropriate activities. Our objective was to better define the clinical characteristics associated with vertebral fractures (VF) in survivors of childhood ALL. Our study, part of the PETALE project, draws its subjects from a pool of 350 French-Canadian ALL patients aged under 19 at diagnostic whom have been in remission for at least 5 years post-diagnostic.

The patients for this study (n=150) were recruited as part of the PETALE project at Sainte-Justine UHC: 59% are females; the mean age at diagnostic of 5.6±4.2 years; mean age at recruitment of 22.3±6.7 years; 59% of patients were classified as high risk at diagnosis; treatment duration was on average 26±4.7 months and was finished 171.6±70.6 months ago. Lateral thoraco-lumbar spine radiograph and LS BMD were assessed. VF was assessed according to the Genant method. Results show a VF prevalence of 18%. Participants with VF had a median age of 6 years old at ALL diagnosis (2–17). No significant difference was observed between patients with VF compared to those without for (n=118): dose of radiation; glucocorticoid cumulative dose; LS BMD z-score; back pain, and vitamin D status.

The mechanisms by which VF occur in survivors of childhood ALL remains an open question. We will next investigate association of VFs with rare and common genetic variants. This may lead to new interventions and insights into osteoporosis prevention.

The PETALE project is funded by a CIHR team grant.

Disclosure: The authors declared no competing interests.