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

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.

%B Br J Haematol %V 176 %P 637-642 %8 2017 02 %G eng %N 4 %1 http://www.ncbi.nlm.nih.gov/pubmed/27891588?dopt=Abstract %R 10.1111/bjh.14452