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Journal of Pediatric Oncology Nursing
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Bone Mineral Density Decrements and Children Diagnosed With Cancer

Jesica Pagano-Therrien, MSN, RN, CPNP

Children’s National Medical Center, Washington, DC, jpagano{at}cnmc.org

Sheila Judge Santacroce, PhD, APRN, CPNP

Yale University School of Nursing, HEROS Program at the Department of Pediatrics, Yale University School of Medicine, New Haven, CT

This integrative literature review is focused on (1) the prevalence of bone mineral density (BMD) decrements in children treated for acute lymphoblastic leukemia (ALL), and when these decrements are observed; (2) the risk factors associated with the development of decreased BMD and resultant complications in children treated for ALL; (3) the role, if any, that corticosteroids play in decreasing BMD in children treated for ALL; (4) interventions that can potentially manage bone loss in people treated for ALL during childhood or adolescence. The results showed that people who have been diagnosed with ALL can have decrements in BMD. The etiology of BMD decrements can be attributed to multiple factors including genetic endowment, lifestyle behaviors, the leukemia disease process, and treatment exposures especially to corticosteroids and cranial radiotherapy. Male gender, age greater than 10 years, and physical inactivity are associated with BMD decrements in ALL survivors. The role of pediatric oncology nurses in the management of bone disease in children with cancer across the illness trajectory is discussed.

Key Words: osteoporosis • acute lymphoblastic leukemia • bone mineral density • childhood cancer survivor

Journal of Pediatric Oncology Nursing, Vol. 22, No. 6, 328-338 (2005)
DOI: 10.1177/1043454205281760
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