Hip Bone Density Deficits Persist After High-Risk Acute Lymphoblastic Leukaemia Treatment

A population-based matched cross-sectional study in Pediatric Blood & Cancer assessed bone mineral density (BMD) after contemporary acute lymphoblastic leukaemia (ALL) treatment. The Danish ALL-STAR cohort included 298 survivors diagnosed at ages 1–45 years between 2008 and 2019 and treated under the NOPHO ALL2008 protocol, alongside 346 age- and sex-frequency matched controls. Participants underwent dual-energy x-ray absorptiometry during 2019–2024, at least one year after completing therapy. BMD comparisons were adjusted for sex, age and height.

Median age at follow-up was 14.1 years, and median time since diagnosis was 6.9 years. Deficits were greatest at hip sites, particularly among high-risk–treated survivors. In this group, adjusted mean BMD relative to controls was 91.2% at the femoral neck (95% CI 88.2–94.4), 90.1% at the total hip (86.9–93.3), and 90.3% at the trochanter (87.0–93.7). Longer time since diagnosis was associated with partial normalisation in standard- and intermediate-risk groups, but not in the high-risk group.

These findings support long-term skeletal health monitoring, particularly after high-risk treatment. However, the cross-sectional design cannot establish individual recovery trajectories. The available abstract does not report fracture outcomes, limiting conclusions about the clinical consequences of the observed BMD deficits.