Osteoporotic fractures secondary to methotrexate therapy of acute leukemia in remission

Abstract

Four of 11 children with acute lymphoblastic leukemia on long-term methotrexate therapy developed severe bone pain in their distal extremities. All were in good clinical and hematologic remission. Radiologic examination revealed severe osteoporosis with associated fractures in 5 of these 11 children. A trial of local radiotherapy was attempted in one patient with no response. Methotrexate therapy was stopped in 4 patients with marked improvement in their bone pain and osteoporotic lesions.