This report presents two cases of childhood acute lymphoblastic leukemia with osteoporosis and vertebral compression fractures. In both cases, the patients had low leukocyte counts with few or no circulating lymphoblasts, normal platelet counts, and little organomegaly or adenopathy. Both patients easily entered to complete remission, and their skeletal lesions gradually improved. One of the cases at diagnosis had an elevation of serum prostaglandin E, which decreased to normal level after the induction therapy. This observation suggested that his skeletal changes might be related to prostaglandin E.
