Bone mineral density and vertebral fractures in teenage and young adult patients with acute lymphoblastic leukaemia. a report from the british osteonecrosis study

Aidan Kirk; Beki James; Richard Feltbower; Talat Mushtaq; Elizabeth Whitehead; Jeannette Kraft; Jayashree Motwani; Holly Parkin; Jane Guest; Juliet Gray; Jenni Palmer; Jennifer Pelling; Jenny Appleby; Naomi Ledwich; Tatendashe Dondo; Nadia Amin

doi:10.1530/endoabs.111.P11

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Endocrine Abstracts (2025) 111 P11 | DOI: 10.1530/endoabs.111.P11

BSPED2025 Poster Presentations Bone (8 abstracts)

Bone mineral density and vertebral fractures in teenage and young adult patients with acute lymphoblastic leukaemia. a report from the british osteonecrosis study

Aidan Kirk ¹ , Beki James ² , Richard Feltbower ³ , Talat Mushtaq ² , Elizabeth Whitehead ² , Jeannette Kraft ² , Jayashree Motwani ⁴ , Holly Parkin ⁴ , Jane Guest ⁴ , Juliet Gray ⁵ , Jenni Palmer ⁶ , Jennifer Pelling ⁶ , Jenny Appleby ⁶ , Naomi Ledwich ⁶ , Tatendashe Dondo ³ & Nadia Amin ²

Author affiliations

¹Mid Yorkshire Teaching Hospital NHS Trust, Wakefield, United Kingdom; ²Leeds Children’s Hospital, Leeds, United Kingdom; ³Leeds Institute for Data Analytics, Leeds, United Kingdom; ⁴Birmingham Children’s Hospital, Birmingham, United Kingdom; ⁵Centre for Cancer Immunology, Southampton, United Kingdom; ⁶Southampton Children’s Hospital, Southampton, United Kingdom

Introduction: The British Osteonecrosis Study (BONES) is the first multicentre prospective study assessing bone health and vertebral fractures in patients aged 10-24 in the UK undergoing treatment for acute lymphoblastic leukaemia (ALL) or lymphoblastic lymphoma (LBL).

Methods: 61 patients were recruited from 3 tertiary centres in the UK. Dual-energy x-ray absorptiometry (DXA) scans with vertebral fracture analysis were performed within 4 weeks of diagnosis and annually for 3 years. Subjective pain assessments were performed at the same timepoints.

Results: Bone mineral density (assessing total body less head (TBLH) significantly reduced after 2-years, compared to baseline (estimate = -0.964, 95% CI [-1.357, -0.572]), with greatest decrease occurring within the first year. Vertebral fracture prevalence was 4.9%, with 2 further patients experiencing incident vertebral fractures. All vertebral fractures occurred in male patients, 75% of whom were British Asian. Back pain was not a predictor of low BMD or vertebral fractures.

Discussion: We report a lower vertebral fracture prevalence in patients aged 10-24 with ALL than has been previously reported in a cohort of younger patients. Male British Asian patients appeared to be at higher risk of vertebral fractures in this study. BMD and pain were not predictors of vertebral fractures.