Skeletal complications of childhood cancer

Manasa Mantravadi, Linda DiMeglio

Research output: Chapter in Book/Report/Conference proceedingChapter


Childhood cancer is often associated with a variety of factors that have detrimental effects on bone health. Cancer treatments can also more directly be associated with skeletal complications such as decreased bone mineral density (BMD), altered epiphyseal growth, and avascular necrosis. During treatment for acute lymphocytic leukemia (ALL), BMD also decreases significantly. Numerous factors that can be associated with BMD deficits including high cumulative steroid doses, methotrexate use, hematopoietic cell transplant (HCT), cranial irradiation, and testicular irradiation, are often inherent to ALL treatment. Failure to accrue sufficient bone mineral during childhood and adolescence increases the risk for early onset osteoporosis among childhood cancer survivors and places them at risk for fractures, particularly later in life. Chemotherapy directly interferes with bone growth in several ways including inhibition of chondrocyte destruction. Avascular necrosis (AVN), also known as aseptic osteonecrosis, is a known complication of chemotherapy and glucocorticoid use.

Original languageEnglish (US)
Title of host publicationPrimer on the Metabolic Bone Diseases and Disorders of Mineral Metabolism
Number of pages6
ISBN (Electronic)9781119266594
ISBN (Print)9781119266563
StatePublished - Jan 1 2018


  • Acute lymphocytic leukemia
  • Aseptic osteonecrosis
  • Bone mineral density
  • Chemotherapy
  • Childhood cancer
  • Hematopoietic cell transplant
  • Skeletal complications

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)

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