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Osteonecrosis in children with acute lymphoblastic leukemia.
Kunstreich, Marina; Kummer, Sebastian; Laws, Hans-Juergen; Borkhardt, Arndt; Kuhlen, Michaela.
Afiliación
  • Kunstreich M; University of Duesseldorf, Medical Faculty, Department of Pediatric Oncology, Hematology, and Clinical Immunology, Center for Child and Adolescent Health, Germany.
  • Kummer S; University of Duesseldorf, Medical Faculty, Department of General Pediatrics, Neonatology and Pediatric Cardiology, Center for Child and Adolescent Health, Germany.
  • Laws HJ; University of Duesseldorf, Medical Faculty, Department of Pediatric Oncology, Hematology, and Clinical Immunology, Center for Child and Adolescent Health, Germany.
  • Borkhardt A; University of Duesseldorf, Medical Faculty, Department of Pediatric Oncology, Hematology, and Clinical Immunology, Center for Child and Adolescent Health, Germany.
  • Kuhlen M; University of Duesseldorf, Medical Faculty, Department of Pediatric Oncology, Hematology, and Clinical Immunology, Center for Child and Adolescent Health, Germany michaela.kuhlen@med.uni-duesseldorf.de.
Haematologica ; 101(11): 1295-1305, 2016 11.
Article en En | MEDLINE | ID: mdl-27742768
The morbidity and toxicity associated with current intensive treatment protocols for acute lymphoblastic leukemia in childhood become even more important as the vast majority of children can be cured and become long-term survivors. Osteonecrosis is one of the most common therapy-related and debilitating side effects of anti-leukemic treatment and can adversely affect long-term quality of life. Incidence and risk factors vary substantially between study groups and therapeutic regimens. We therefore analyzed 22 clinical trials of childhood acute lymphoblastic leukemia in terms of osteonecrosis incidence and risk factors. Adolescent age is the most significant risk factor, with patients >10 years old at the highest risk. Uncritical modification or even significant reduction of glucocorticoid dosage cannot be recommended at this stage. A novel and innovative approach to reduce osteonecrosis-associated morbidity might be systematic early screening for osteonecrosis by serial magnetic resonance images. However, discriminating patients at risk of functional impairment and debilitating progressive joint disease from asymptomatic patients still remains challenging.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Osteonecrosis / Leucemia-Linfoma Linfoblástico de Células Precursoras Tipo de estudio: Etiology_studies / Guideline / Risk_factors_studies Aspecto: Patient_preference Límite: Adolescent / Child / Humans Idioma: En Revista: Haematologica Año: 2016 Tipo del documento: Article País de afiliación: Alemania Pais de publicación: Italia
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Osteonecrosis / Leucemia-Linfoma Linfoblástico de Células Precursoras Tipo de estudio: Etiology_studies / Guideline / Risk_factors_studies Aspecto: Patient_preference Límite: Adolescent / Child / Humans Idioma: En Revista: Haematologica Año: 2016 Tipo del documento: Article País de afiliación: Alemania Pais de publicación: Italia