uu.seUppsala University Publications
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Comparing osteonecrosis clinical phenotype, timing, and risk factors in children and young adults treated for acute lymphoblastic leukemia
Rigshosp, Univ Hosp, Juliane Marie Ctr, Dept Pediat & Adolescent Med, JMC 5704,Blegdamsvej 9, DK-2100 Copenhagen, Denmark.
Karolinska Inst, Dept Womens & Childrens Hlth, Childhood Canc Res Unit, Stockholm, Sweden.
Karolinska Inst, Dept Mol Med & Surg, Stockholm, Sweden;Karolinska Inst, Ctr Mol Med, Stockholm, Sweden;Karolinska Univ Hosp, Dept Clin Genet, Stockholm, Sweden.
Karolinska Inst, Dept Womens & Childrens Hlth, Childhood Canc Res Unit, Stockholm, Sweden.
Show others and affiliations
2018 (English)In: Pediatric Blood & Cancer, ISSN 1545-5009, E-ISSN 1545-5017, Vol. 65, no 10, article id e27300Article in journal (Refereed) Published
Abstract [en]

Background: Treatment-related osteonecrosis (ON) is a serious complication of treatment of acute lymphoblastic leukemia (ALL).

Procedure: This study included 1,489 patients with ALL, aged 1-45years, treated according to the Nordic Society of Paediatric Haematology and Oncology ALL2008 protocol, using alternate-week dexamethasone during delayed intensification, with prospective registration of symptomatic ON. We aimed at comparing risk factors, timing, and clinical characteristics of ON in children and young adults.

Results: ON was diagnosed in 67 patients, yielding a 5-year cumulative incidence of 6.3%, but 28% in female adolescents. Median age at ALL diagnosis was 12.1years and 14.9years for females and males, respectively. At ON diagnosis, 59 patients had bone pain (91%) and 30 (46%) had multiple-joint involvement. The median interval between ALL and ON diagnosis was significantly shorter in children aged 1.0-9.9years (0.7years [range: 0.2-2.1]) compared with adolescents (1.8years [range: 0.3-3.7, P<0.001]) and adults (2.1years [range: 0.4-5.3, P=0.001]). Female sex was a risk factor in adolescent patients (hazard ratio [HR]=2.1, 95% confidence interval [CI]: 1.1-4.2) but not in children aged 1.1-9.9years (HR=2.4, 95% CI: 0.9-6.2, P=0.08) or adults aged 19-45years (HR=1.1, 95% CI: 0.3-4.0). Age above 10years at ALL diagnosis (odds ratio [OR]=3.7, P=0.026) and multiple joints affected at ON diagnosis (OR=3.4, P=0.027) were risk factors for developing severe ON.

Conclusion: We provide a detailed phenotype of patients with ALL with symptomatic ON, including description of risk factors and timing of ON across age groups. This awareness is essential in exploring measures to prevent development of ON.

Place, publisher, year, edition, pages
WILEY , 2018. Vol. 65, no 10, article id e27300
Keywords [en]
acute lymphoblastic leukemia, osteonecrosis, phenotype, risk factors
National Category
Hematology
Identifiers
URN: urn:nbn:se:uu:diva-362090DOI: 10.1002/pbc.27300ISI: 000442500600038PubMedID: 29943905OAI: oai:DiVA.org:uu-362090DiVA, id: diva2:1253045
Funder
Swedish Childhood Cancer FoundationAvailable from: 2018-10-03 Created: 2018-10-03 Last updated: 2018-10-03Bibliographically approved

Open Access in DiVA

No full text in DiVA

Other links

Publisher's full textPubMed

Authority records BETA

Hallböök, Helene

Search in DiVA

By author/editor
Hallböök, HeleneFrandsen, Thomas Leth
By organisation
Haematology
In the same journal
Pediatric Blood & Cancer
Hematology

Search outside of DiVA

GoogleGoogle Scholar

doi
pubmed
urn-nbn

Altmetric score

doi
pubmed
urn-nbn
Total: 13 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf