Whole-body MRI reveals high incidence of osteonecrosis in children treated for Hodgkin lymphoma

Annemieke S. Littooij, Thomas C. Kwee, Goya Enríquez, Jonathan I M L Verbeke, Claudio Granata, Auke Beishuizen, Charlotte de Lange, Floriana Zennaro, Marrie C A Bruin, Rutger A J Nievelstein

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish
Pages (from-to)637-642
Number of pages6
JournalBritish Journal of Haematology
Volume176
Issue number4
DOIs
Publication statusPublished - Feb 2017

Keywords

  • Journal Article

Fingerprint Dive into the research topics of 'Whole-body MRI reveals high incidence of osteonecrosis in children treated for Hodgkin lymphoma'. Together they form a unique fingerprint.

Cite this