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- Title
Whole-body MRI reveals high incidence of osteonecrosis in children treated for Hodgkin lymphoma.
- Authors
Littooij, Annemieke S.; Kwee, Thomas C.; Enríquez, Goya; Verbeke, Jonathan I. M. L.; Granata, Claudio; Beishuizen, Auke; Lange, Charlotte; Zennaro, Floriana; Bruin, Marrie C. A.; Nievelstein, Rutger A. J.
- Abstract
Osteonecrosis is a well-recognized complication in patients treated with corticosteroids. The incidence of osteonecrosis in children treated for Hodgkin lymphoma is unknown because prospective whole-body magnetic resonance imaging ( MRI) studies are lacking in this patient population. Paediatric patients with newly diagnosed Hodgkin lymphoma who were treated according to a uniform paediatric Hodgkin protocol were eligible for inclusion in this prospective study. Whole-body MRI was performed in all 24 included patients (mean age 15·1 years, 12 girls) both before treatment and after 2 cycles of chemotherapy, and in 16 patients after completion of chemotherapy. Osteonecrosis was identified in 10 patients (41·7%, 95% confidence interval: 22·0-61·4%), with a total of 56 osteonecrotic sites. Osteonecrosis was detected in 8 patients after 2 cycles of OEPA (vincristine, etoposide, prednisone, doxorubicin), and in 2 additional patients after completion of chemotherapy. Epiphyseal involvement of long bones was seen in 4 of 10 children. None of the patients with osteonecrosis had any signs of bone collapse at the times of scanning. Whole-body MRI demonstrates osteonecrosis to be a common finding occurring during therapy response assessment of paediatric Hodgkin lymphoma. Detection of early epiphyseal osteonecrosis could allow for treatment before bone collapse and joint damage may occur.
- Subjects
OSTEONECROSIS; PHYSIOLOGICAL effects of adrenocortical hormones; HODGKIN'S disease in children; MAGNETIC resonance imaging; CANCER chemotherapy
- Publication
British Journal of Haematology, 2017, Vol 176, Issue 4, p637
- ISSN
0007-1048
- Publication type
Article
- DOI
10.1111/bjh.14452