Osteonecrosis in Children Treated for Lymphoma or Solid Tumors

Niinimäki, Riitta; Harila‐Saari, Arja; Jartti, Airi; Seuri, Raija; Riikonen, Pekka; Pääkkö, Eija; Möttönen, Merja; Lanning, Marjatta

doi:10.1097/mph.0b013e31818ab29d

Cited by 20 publications

(23 citation statements)

References 26 publications

(33 reference statements)

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“…Consistent with previous reports 1,2,16,17,27,39 , we found multi-articular involvement in our cohort. However, whereas previous studies using symptom-driven imaging to document ON indicated an increased frequency of hip involvement1,4,6,28,29, our study, using prospective imaging, indicated knee involvement to be more frequent than hip involvement 7,16.…”

Section: Discussionsupporting

confidence: 93%

Prevalence of osteonecrosis and associated risk factors in children before allogeneic BMT

Sharma

Yang

Rochester

et al. 2010

Bone Marrow Transplant

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Osteonecrosis (ON) is a debilitating long-term complication of allogenic bone marrow transplantation (alloBMT) but may begin before alloBMT in some children because of their primary disease treatment. Therefore, to estimate the prevalence and associated risk factors for ON before alloBMT, we conducted a retrospective analysis of magnetic resonance (MR) studies of 118 children who underwent first alloBMT at our institution between December 2000 and September 2007. Of the 118 consecutive patients, 107 (90.7%) underwent prospective MR studies irrespective of symptoms (69 males; median age at alloBMT 12.9 years), and 11 underwent MR studies for symptoms. Amongst the 107 who had prospective imaging, 23 (21.5%) had ON; nearly 50% had at least 30% epiphyseal involvement. Knees were more frequently involved than were hips; severity of ON was greater in hips. ON prevalence before alloBMT was 23.72% when all 118 patients were included in the denominator. Risk factor analysis, limited to MR studies performed irrespective of symptoms, revealed female gender (P = 0.049) and age ≥10 years at the time of MR study (P = 0.03) as significant risk factors and primary diagnosis of lymphoid malignancies and aplastic anemia trended towards significance. ON prior to alloBMT is a common occurrence in children.

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Section: Discussionsupporting

confidence: 93%

Prevalence of osteonecrosis and associated risk factors in children before allogeneic BMT

Sharma

Yang

Rochester

et al. 2010

Bone Marrow Transplant

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“…This has been carried out by Ribeiro et al 33 one year after diagnosis of ALL, by Niinimäki et al 86 at the end of therapy, by Kaste et al 87 at 6.5 and 9 months from diagnosis and at completion of therapy, and by Kawedia et al 6 after reinduction I and II and at completion of therapy. The number of patients diagnosed with radiographic osteonecrosis was high (15.5%, 33 24% 86 and 71.8%, 6 respectively) with a substantial proportion of patients remaining asymptomatic until the end of the study (35%, 70%, and 73%, respectively).…”

Section: Prevention and Screeningmentioning

confidence: 99%

Osteonecrosis in children with acute lymphoblastic leukemia

et al. 2016

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“…In children, only osteonecrosis of long bones has been reported in patients treated for ALL [15,16]. Corticosteroids are integral to the management of childhood ALL and are probably what contributes to the dramatic increase in the occurrence of osteonecrosis in children.…”

Section: Discussionmentioning

confidence: 97%

“…In children osteonecrosis of long bones is a well-documented complication of intensive chemotherapy for acute lymphoblastic leukemia (ALL), including multiple courses of corticosteroids [15,16]; however, no case of osteonecrosis, specifically of the jaw, has ever been reported in children.…”

Section: Introductionmentioning

confidence: 99%

Children and adolescents treated with neridronate for osteogenesis imperfecta show no evidence of any osteonecrosis of the jaw

et al. 2011

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Over recent years, several reports have been published on unusual cases of osteonecrosis of the jaw (ONJ) in adults using second- and third-generation nitrogen-containing bisphosphonates such as pamidronate, alendronate, risedronate and zoledronate, but no case has ever been reported either in children or in adult patients taking neridronate. Children and adolescents affected by osteogenesis imperfecta (OI) could belong to a high-risk group for ONJ because bone fragility in OI is associated with a connective tissue malfunction. The purpose of this study is to evaluate the incidence of ONJ in a pediatric population treated with neridronate for OI. A total of 102 pediatric patients with OI who received neridronate infusions for a mean of 6.81 years (SD ± 3.06 years) were clinically assessed for possible ONJ. Eligibility criteria for participation included patients between 1.2 and 24 years old who received cyclical neridronate infusions for at least 1 year. All the patients were reviewed to determine duration, dosage and cumulative dose of their bisphosphonate therapy and were examined clinically to assess their oral health status. We have not demonstrated any occurrence of ONJ in our patients. In conclusion, at the moment insufficient data are available to prove a greater risk of ONJ in children with OI than in children affected by other forms of bone fragility. However, cases may emerge in future because the risk of ONJ seems to be related to the cumulative dose and the duration of therapy.

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Osteonecrosis in Children Treated for Lymphoma or Solid Tumors

Abstract: ON in MRI was found to be a common complication in children after treatment for HD or NHL. The risk for ON seems to be very low in patients with other solid tumors even when they receive high cumulative doses of dexamethasone.

Cited by 20 publications

References 26 publications

Prevalence of osteonecrosis and associated risk factors in children before allogeneic BMT

Prevalence of osteonecrosis and associated risk factors in children before allogeneic BMT

Osteonecrosis in children with acute lymphoblastic leukemia

Children and adolescents treated with neridronate for osteogenesis imperfecta show no evidence of any osteonecrosis of the jaw

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