{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T01:14:37Z","timestamp":1760058877509,"version":"build-2065373602"},"reference-count":41,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2025,5,1]],"date-time":"2025-05-01T00:00:00Z","timestamp":1746057600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Childhood leukemia survivors are at risk of long-term complications. Data on bone remodeling in childhood acute lymphoblastic leukemia (ALL) are limited. This 2-year prospective longitudinal study investigated bone remodeling and bone turnover markers at diagnosis, during treatment, and until stopping treatment, in ALL patients &lt; 18 years, to clarify the influence of leukemia itself and\/or chemotherapy on bone. Methods: A total of 22 ALL children (12 males, age 5.5 \u00b1 3.6 years) underwent blood sampling at the 5 time point (T0\u2212T4). Osteoprotegerin (OPG), receptor-activator-NF-B-ligand (RANKL), osteocalcin (OC), C-terminal-telopeptide-type-I-collagen (CTX), bone-alkaline-phosphatase (bALP), tartrate-resistant acid-phosphatase-5b (TRACP5b), procollagen-type-I-N-terminal-propeptide (P1NP), Dickkopf-1 (DKK-1), and sclerostin were assessed. Data from patients at T0 were compared to a control group of healthy children. We used the principal component analysis (PCA) for statistics. Results: Levels of CTX, OC, P1NP, and bALP resulted lower in ALL children than controls (p = 0.009 for CTX and p &lt; 0.001 for the others), also DKK1 and sclerostin (p &lt; 0.0001 and p = 0.023). RANKL ed OPG were higher in patients. During T0\u2212T4, CTX, OC, P1NP, TRACP5b, and bALP showed a significant increase, in particular at T0\u2212T1 (end-of-induction). Less evident changes were detected onwards. Conclusions: The onset of leukemia has been revealed as a key point in determining a slowing of bone remodeling in ALL children.<\/jats:p>","DOI":"10.3390\/ijms26094307","type":"journal-article","created":{"date-parts":[[2025,5,1]],"date-time":"2025-05-01T09:16:12Z","timestamp":1746090972000},"page":"4307","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Bone Remodeling in Children with Acute Lymphoblastic Leukemia: A Two-Year Prospective Longitudinal Study"],"prefix":"10.3390","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8813-3200","authenticated-orcid":false,"given":"Paola","family":"Muggeo","sequence":"first","affiliation":[{"name":"Department of Pediatric Oncology and Hematology, University Hospital of Policlinico, 70124 Bari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6705-6354","authenticated-orcid":false,"given":"Massimo","family":"Grassi","sequence":"additional","affiliation":[{"name":"Department of Pediatric Oncology and Hematology, University Hospital of Policlinico, 70124 Bari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7344-9712","authenticated-orcid":false,"given":"Vito","family":"D\u2019Ascanio","sequence":"additional","affiliation":[{"name":"Institute of Sciences of Food Production (ISPA), Italian National Research Council (CNR), 70126 Bari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-1440-0861","authenticated-orcid":false,"given":"Jessica","family":"Forte","sequence":"additional","affiliation":[{"name":"Pediatric Department, Ospedale Della Murgia \u201cF. Perinei\u201d, 70022 Altamura, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vincenzo","family":"Brescia","sequence":"additional","affiliation":[{"name":"Clinical Pathology Unit, AOU Policlinico Consorziale di Bari-Ospedale Giovanni XXIII, 70124 Bari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6089-1165","authenticated-orcid":false,"given":"Francesca","family":"Di Serio","sequence":"additional","affiliation":[{"name":"Clinical Pathology Unit, AOU Policlinico Consorziale di Bari-Ospedale Giovanni XXIII, 70124 Bari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura","family":"Piacente","sequence":"additional","affiliation":[{"name":"Pediatric Unit, Department of Precision and Regenerative Medicine and Ionian Area (DiMePre-J), Medical School, University of Bari \u201cAldo Moro\u201d, Piazza G. Cesare 11, 70124 Bari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paola","family":"Giordano","sequence":"additional","affiliation":[{"name":"Interdisciplinary Department of Medicine, University of Bari \u201cAldo Moro\u201d, 70124 Bari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8853-6536","authenticated-orcid":false,"given":"Nicola","family":"Santoro","sequence":"additional","affiliation":[{"name":"Department of Pediatric Oncology and Hematology, University Hospital of Policlinico, 70124 Bari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1899-8337","authenticated-orcid":false,"given":"Maria Felicia","family":"Faienza","sequence":"additional","affiliation":[{"name":"Pediatric Unit, Department of Precision and Regenerative Medicine and Ionian Area (DiMePre-J), Medical School, University of Bari \u201cAldo Moro\u201d, Piazza G. Cesare 11, 70124 Bari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,5,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"83","DOI":"10.3322\/caac.21219","article-title":"Childhood and adolescent cancer statistics, 2014","volume":"64","author":"Ward","year":"2014","journal-title":"CA Cancer J. 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