Comparison of Bone Profile Based on Risk Stratification in Children with Acute Lymphoblastic Leukemia at Adam Malik Hospital

Author : Pramulya Prajogo

Abstract : Background: Acute lymphoblastic leukemia (ALL) represents the most frequent malignancy in childhood. Although survival outcomes have markedly improved, attention has shifted toward treatment-related complications, including disturbances in bone metabolism. Differences in treatment intensity according to risk stratification may contribute to variations in bone biochemical parameters. Objective: To evaluate differences in bone biochemical profiles between standard-risk and high-risk children with ALL treated at Adam Malik Hospital Methods: A cross-sectional analytical study was conducted using retrospective medical records of 50 pediatric patients diagnosed with ALL. Patients were classified into standard-risk and high-risk groups based on established treatment protocols. Serum levels of calcium, magnesium, phosphate, alkaline phosphatase (ALP), and 25-hydroxyvitamin D were analyzed. Statistical comparisons were performed using independent t-test or Mann–Whitney test according to data distribution. Results: Children in the high-risk group showed significantly lower levels of calcium (p=0.036), magnesium (p=0.049), phosphate (p=0.009), and vitamin D (p=0.005) compared with the standard risk group. No statistically significant difference was observed in ALP levels (p=0.214). A longer duration of glucocorticoid exposure was also noted in the high-risk group (p=0.036). Conclusion: High-risk pediatric ALL patients exhibit greater alterations in bone biochemical parameters, particularly in magnesium, phosphate, and vitamin D levels.

Keywords : Acute lymphoblastic leukemia, risk stratification, bone metabolism, vitamin D, pediatrics.

Conference Name : International Conference on Pediatric Cardiology and Critical Care Research (ICPCCCR-26)

Conference Place : Shah Alam, Malaysia

Conference Date : 12th Mar 2026