Multifocal osteonecrosis in children and adolescents after polychemotherapy

Zeitschrift für Orthopädie und ihre Grenzgebiete
P RaabR Krauspe

Abstract

Adequate treatment protocols provide excellent results in management of lymphoma, leukemia and other malignancies in children. With improved survival rates, therapy related sequaela like osteonecrosis (avascular necrosis of bone, AVN) have become a matter of increasing concern. From 1982 to 1992 121 patients were treated for acute lymphocytic leukemia, acute myelocytic leukemia, Hodgkin's Lymphoma, Non-Hodgkin's Lymphoma and Langerhanscell-histiocytosis. All patients were treated with multiagent regimes that included low-dose steroid therapy. 23 patients died, but 64 patients could be evaluated 4 to 14 years after chemotherapy. If the patient complained of bone or joint pain or other clinical findings were suspicious for bony lesions, radiological evaluation was made to get prove of AVN. Six out of 64 patients developed AVN at 17 different sites. Four patients had multifocal AVN. The interval between induction chemotherapy and onset of symptoms was at average 12 months. The average cumulative steroid dosage was 4.25 g. AVN did not relate to sex, diagnosis or a single agent, but did relate to age. There were no cases of AVN in patients younger than 10 years of age. Four patients required surgical intervention. AVN after polychem...Continue Reading

Citations

Aug 5, 2004·Der Schmerz·M JägerR Krauspe
Jan 23, 2008·Der Orthopäde·B WesthoffR Krauspe
Jul 13, 2002·Medical and Pediatric Oncology·B BernbeckU Göbel
May 14, 2008·La Chirurgia degli organi di movimento·Giuseppe SolarinoBerenice De Cillis
Sep 15, 2006·International Journal of Hyperthermia : the Official Journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group·S BalzerR Wessalowski

❮ Previous
Next ❯

Related Concepts

Related Feeds

B-Cell Lymphoma

B-cell lymphomas include lymphomas that affect B cells. This subtype of cancer accounts for over 80% of non-Hodgkin lymphomas in the US. Here is the latest research.

AML: Role of LSD1 by CRISPR (Keystone)

Find the latest rersearrch on the ability of CRISPR-Cas9 mutagenesis to profile the interactions between lysine-specific histone demethylase 1 (LSD1) and chemical inhibitors in the context of acute myeloid leukemia (AML) here.

Acute Myeloid Leukemia

Acute myeloid leukemia (AML) is a clinically and genetically heterogeneous disease with approximately 20,000 cases per year in the United States. AML also accounts for 15-20% of all childhood acute leukemias, while it is responsible for more than half of the leukemic deaths in these patients. Here is the latest research on this disease.

Blood And Marrow Transplantation

The use of hematopoietic stem cell transplantation or blood and marrow transplantation (bmt) is on the increase worldwide. BMT is used to replace damaged or destroyed bone marrow with healthy bone marrow stem cells. Here is the latest research on bone and marrow transplantation.