TY - JOUR T1 - Whole-body MRI reveals high incidence of osteonecrosis in children treated for Hodgkin lymphoma. JF - Br J Haematol Y1 - 2017 A1 - Littooij, Annemieke S A1 - Kwee, Thomas C A1 - Enríquez, Goya A1 - Verbeke, Jonathan I M L A1 - Granata, Claudio A1 - Beishuizen, Auke A1 - de Lange, Charlotte A1 - Zennaro, Floriana A1 - Bruin, Marrie C A A1 - Nievelstein, Rutger A J KW - Adolescent KW - Antineoplastic Combined Chemotherapy Protocols KW - Child KW - Doxorubicin KW - Epiphyses KW - Etoposide KW - Female KW - Hodgkin Disease KW - Humans KW - Incidence KW - Magnetic Resonance Imaging KW - Male KW - Osteonecrosis KW - Prednisone KW - Prospective Studies KW - Vincristine AB -

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.

VL - 176 IS - 4 U1 - http://www.ncbi.nlm.nih.gov/pubmed/27891588?dopt=Abstract ER -