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Clinical Manifestation of Childhood Acute Leukemia with Bone Involvement

Journal of the Korean Pediatric Society 2000;43(6):806-813.
Published online June 15, 2000.
Clinical Manifestation of Childhood Acute Leukemia with Bone Involvement
Kyoung Eun Jeong1, Hee Jung Lee2, Kwang Soon Song3, Heung Sik Kim1, Chin Moo Kang1
1Department of Pediatrics, Keimyung University, School of Medicine, Taegu, Korea
2Department of Radiology, College of Medicine, Soonchunhyang University, Seoul, Korea
3Department of Orthopedics, Keimyung University, School of Medicine, Taegu, Korea
골 침범이 동반된 소아 급성 백혈병의 임상양상
정경은1, 이희정2, 송광순3, 김흥식1, 강진무1
1계명대학교 의과대학 소아과학교실
2계명대학교 의과대학 진단방사선과학교실
3계명대학교 의과대학 정형외과학교실
: Bone involvement is known to develop in 40-70% of pediatric acute leukemia. We aimed to analyze the clinical course and result of therapy in pediatric acute leukemia with bone involvement.
: Twenty-seven patients diagnosed as pediatric acute leukemia at Dong San Medical Center from Jan. 1996 to Aug. 1998 were evaluated. According to bone X-ray and whole body bone scan, the patients were divided into two groups.
: Twenty-seven patients were enrolled in this study with 14 patients(52%) showing definite bone involvement on simple X-ray or bone scan. Mean age of patients with bone involvement was 5.5 years. Regarding the type of leukemia, 9 patients(64%) were acute lymphocytic leukemia. Ten patients(71%) out of 14 with bone involvement complained of bone pain at the involved bony site. Site of involvement was most frequent in the lower extremity. On simple X-ray, osteolytic lesion was found in 7 patients(50%), diffuse osteopenia in 2 patients(14%) and pathologic fracture in 2 patients(14%). In bone scan, radioactivity was increased in whole cases of patients with bone involvement. Thirteen patients(93%) were completely remitted by chemotherapy, but, one AML patient died due to induction failure.
: Bone involvement occured in 52% of pediatric acute leukemia. Bone involvement was more frequent in male patients in the lower extremity, and osteolytic lesion was the most frequent finding on simple X-ray. There was no relevence between bone involvement and prognosis. Further study will be needed to evaluate long-term survival and prognosis.
Key Words: Bone involvement, Pediatric acute leukemia

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