Bone Mineral Density, Lean Body Mass and Bone Biomarkers Following Physical Exercise in Children with Acute Lymphoblastic Leukemia Undergoing Chemotherapy

Background: This study was aimed to evaluate the effects of physical exercise on bone mineral density (BMD), lean body mass (LBM) and bone biomarkers in children with acute lymphoblastic leukemia on chemotherapy. Methods: forty-six leukemic children were randomly assigned to two groups; exercise group (E) undergoing supervised mixed exercise program consisting of aerobic, resistance and flexibility training and control group (C) who did not receive any kind of exercise. BMD and LBM were measured by Densitometry (DEXA) and bone biomarkers were assessed through blood sample analysis at baseline, and then 6 and 12 months later. Results: There was marked increase in BMD, LBM and bone biomarkers in response to exercise with the time compared with control group (P<0.001). At the end of the study, the results of the study showed that the percentage of patients with normal lumbar BMD (LBMD) and total BMD (TBMD) in exercise group were 13% and 17.4%, respectively compared to 0% in control group. In addition, the percentage of osteoporotic patients at LBMD & TBMD in exercise group were 21.7% and 17.4%, respectively compared to 78.3% and 52.18% in control group, respectively (P<0.05). Conclusion: It can be concluded that physical exercise could be effective in increasing BMD, LBM and bone biomarkers in children with ALL.