@article {10570,
	title = {Whole-body MRI reveals high incidence of osteonecrosis in children treated for Hodgkin lymphoma.},
	journal = {Br J Haematol},
	volume = {176},
	year = {2017},
	month = {2017 02},
	pages = {637-642},
	abstract = {<p>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{\textperiodcentered}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{\textperiodcentered}7\%, 95\% confidence interval: 22{\textperiodcentered}0-61{\textperiodcentered}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.</p>},
	keywords = {Adolescent, Antineoplastic Combined Chemotherapy Protocols, Child, Doxorubicin, Epiphyses, Etoposide, Female, Hodgkin Disease, Humans, Incidence, Magnetic Resonance Imaging, Male, Osteonecrosis, Prednisone, Prospective Studies, Vincristine},
	issn = {1365-2141},
	doi = {10.1111/bjh.14452},
	author = {Littooij, Annemieke S and Kwee, Thomas C and Enr{\'\i}quez, Goya and Verbeke, Jonathan I M L and Granata, Claudio and Beishuizen, Auke and de Lange, Charlotte and Zennaro, Floriana and Bruin, Marrie C A and Nievelstein, Rutger A J}
}
