Bone marrow changes on MRI in children with acute lymphoblastic leukaemia 5 years after treatment

Ojala, A; Pääkkö, Eija; Lanning, F. P.; Harila‐Saari, Arja; Lanning, B. Marjatta

doi:10.1016/s0009-9260(98)80060-3

Cited by 14 publications

(10 citation statements)

References 43 publications

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“…Nonspecific appearance of bone marrow signal has been reported around the knee in children with leukemia [62][63][64] and is composed of punctuate foci (dotlike abnormalities with 1-to 3-mm diameters with no discernible interior fatlike areas) ( Fig. 3), bone marrow edema (Fig.…”

Section: Coexisting Lesionsmentioning

confidence: 90%

Osteonecrosis in Children After Therapy for Malignancy

Kaste

Karimova

Neel

2011

American Journal of Roentgenology

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OBJECTIVE Osteonecrosis in the growing population of childhood cancer survivors results from disease and treatment. Imagers must be knowledgeable about patient groups at risk for its development, patterns of involvement and potential implications. This review will focus on implications of this potentially life-altering toxicity. CONCLUSION Childhood cancer survivors are at increased risk for developing osteonecrosis. Because osteonecrosis is often asymptomatic until late in the process, imaging is critical for its detection and characterization when interventions may be most effective to ameliorate its progression.

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Section: Coexisting Lesionsmentioning

confidence: 90%

Osteonecrosis in Children After Therapy for Malignancy

Kaste

Karimova

Neel

2011

American Journal of Roentgenology

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“…14 As reported in literature, the overall incidence of symptomatic ON appears to be very variable with percentages ranging from 1% to 38%; this last value was reported in a study that used magnetic resonance imaging for a systematic screening. 15 The controversy concerning incidence rate appears to be the consequence of retrospective studies. 3,12 In our study, the overall incidence of ON was 1.2%, although this percentage has to be reinterpreted in relation to the three levels of risk and gender.…”

Section: Discussionmentioning

confidence: 99%

“…Another controversial point of discussion concerns the type of Ojala and co-workers have reported a cure rate with restitutio ad integrum in approximately 30% of patients, 9 while other multi-center studies have shown that approximately 22-24% of symptomatic patients have undergone at least one orthopedic surgery. 15,23 Currently, in severe and rapidly progressive osteonecrosis, a surgical approach is commonly accepted, associated with no weight bearing and physical exercises. In patients with osteonecrosis, smaller lesions and fewer symptoms, the therapeutic approach is generally more conservative, essentially based on the absolute prohibition of loading and active and passive physiotherapy in open kinetic chain.…”

Section: Discussionmentioning

confidence: 99%

Osteonecrosis as a complication in pediatric patients with acute lymphoblastic leukemia

et al. 2016

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Osteonecrosis is a significant adverse effect of treatment administered to children suffering from acute lymphoblastic leukemia (ALL) that may have a negative effect on the quality of life. The purpose of this study is to evaluate the rate of secondary vascular osteonecrosis (ON) in a population of pediatric patients with ALL treated with corticosteroids and cytostatic agents. A retrospective analysis of prospectively collected data of the medical records of 328 patients with ALL identified 4 cases with ON, corresponding to 1.2% of all cases observed. Of the 4 patients identified in our study 3 were girls and 1 was a boy, aged from 10 to 16 years old (average age at diagnosis, 12 years). Median time between the diagnosis of ALL and ON was 12.5 months (range, 12 to 36 months). Regarding the lesion size of ON, in all cases the femoral head (monolateral in 1 case and bilateral in 3 cases) was involved and was associated with the scapula-humeral joint in one case. ON of the weight-bearing joints has been identified as a severe complication in children with leukemia that may be associated with the development of articular surface collapse, subsequent debilitating arthritis, sometimes needing arthroplasty. For this reason it is very important to implement prevention strategies, especially in adolescent girls treated with steroids and chemotherapy. An early diagnosis of ON and careful orthopedic follow-up are necessary in order to avoid bone deformations related to the late start or the wrong therapy.

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“…Despite their clinical insignificance, as an accidental finding in patients with complete bone marrow remission they can cause confusion. Ojala et al [43] searched for bone marrow changes on MRI in a group of 25 children successfully treated for acute lymphoblastic leukemia. Signal pathologies considered to be related with the disease or its treatment were detected in 9 patients.…”

Section: Sequelae Of Chemo-and Radiotherapymentioning

confidence: 99%

Magnetic Resonance Imaging of the Bone Marrow: Malignant Lymphoma – Multiple Myeloma – Bone Marrow

Golder¹

1999

Oncol Res Treat

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Magnetic resonance imaging (MRI) has become the most applied imaging technique in evaluating lymphomatous diseases, multiple myeloma, myelodysplastic syndromes, and gross therapeutic effects in bone marrow. The tomograms help explain the etiology of pain, palsy, and other clinical symptoms in patients with hematologic malignancies by elucidating osseous and extra-osseous components in their relationships to nerves and vessels. Moreover, MRI permits the detection of bone marrow abnormalities before skeletal lesions become evident on plain radiographs, but it cannot reliably predict the histological nature of a marrow lesion, just like bone marrow scintigraphy. Almost every third of the patients who have had negative bone marrow biopsies for malignant lymphoma, will be recognized as suffering from marrow involvement on a subsequent MR imaging procedure. Consequently, the clinical stage IV will be assigned to a remarkable percentage of patients on the basis of MRI results. In multiple myeloma, MRI has proved to be very reliable for depicting all types of marrow involvement. To assess the local extent of the tumor and to search for other thus far hidden foci of the disease, the technique has become an integral part of the staging procedure in patients with solitary plasmacytoma. All three fundamental MR patterns of abnormal bone marrow have been observed in patients with multiple myeloma, the focal one being most frequent. The prognostic significance of the different MR patterns is controversial. MRI identifies patients at high risk for the development of vertebral collapses, but cannot predict the time and precise level of the fracture. The criteria defined for differentiating benign and malignant vertebral collapses at MRI are quite reliable. Quantitative MRI seems to enable monitoring of treatment response. The typical fatty appearance of the irradiated spine is irreversible for doses exceeding 30 Gy and serves as a dependable indicator for the extent of the irradiation field. MRI can direct harvest procedures for autologous bone marrow transplantation to sites of relatively unaffected marrow. In the evaluation of the status of bone marrow after transplantation, quantitative contrast-enhanced MRI seems to be a promising new tool, because the degree and rate of gadolinium chelate uptake depends on the cellularity of the marrow.

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Bone marrow changes on MRI in children with acute lymphoblastic leukaemia 5 years after treatment

Cited by 14 publications

References 43 publications

Osteonecrosis in Children After Therapy for Malignancy

Osteonecrosis in Children After Therapy for Malignancy

Osteonecrosis as a complication in pediatric patients with acute lymphoblastic leukemia

Magnetic Resonance Imaging of the Bone Marrow: Malignant Lymphoma – Multiple Myeloma – Bone Marrow

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