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İstanbul Üniversitesi Cerrahpaşa Tıp Fakültesi ¹Pediatri Doçenti, ²Pediatri Profesörü, ³Pediatri Araştırma Görevlisi, ⁴Radyoloji Uzmanı Acute lymphoblastic leukemia (ALL) of childhood may frequently present with skeletal changes. The impact of skeletal involvement is controversial. Radiographs and medical charts of 252 ALL patients treated in our institution between 1980 and 1999 were investigated, and skeletal surveys were correlated with age, gender, biological and clinical markers and prognosis. Bone pain was the initial symptom in 35 (13.9%) patients. In 179 patients skeletal surveys were eligible, and 33 patients (18.4%) showed various radiologic abnormalities defined as osteopenia (60.1%), lytic lesions (42%) and periosteal reaction (36%). The patients were grouped according to the number of radiological findings as group 1, without any, as group 2 with 1-3 and group 3 with ³ 4 radiological abnormalities respectively. Metaphyseal band was not observed in group 2 patients compared to 33% in group 3. In contrast, lytic lesions were found in 50% of group 3. The clinical, biological and hematological parameters of the three groups showed no difference. Group 3 patients had the best survival rates. We conclude that the prognostic impact of severe skeletal involvement is an important and independent factor in children with ALL. Anahtar Kelimeler : lösemi, lenfoblastik, kemik tutulumu, radyoloji, prognoz, risk faktörü, lymphoblastic leukemia, skeletal involvement, survival