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On a case of multifocal osteonecrosis in a patient suffering from acute lymphoblastic leukemia

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Abstract

The Authors describe the case of a 14-year-old girl who developed a multifocal osteonecrosis (ON), after treatment with chemotherapy and corticosteroids for acute lymphoblastic leukemia (ALL). She came to our attention about 6 months after the beginning of treatment complaining of pain in her left knee and later in both hips and shoulders. Radiography and MRI confirmed the presence of avascular ON at all these sites. The patient underwent bilateral total hip arthroplasty, which was still functioning well at the last follow-up visits at 5 years, and at 5 years and 4 months. ON is increasingly recognized as a complication of the treatment of cancer in children and adolescents, and as patients now frequently survive ALL into adulthood, orthopedists will be increasingly called on to manage this complication affecting multiple joints in children and young adults.

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References

  1. Murphy RG, Greenberg ML (1990) Osteonecrosis in pediatric patients with acute lymphoblastic leukemia. Cancer 65:1717–1721

    Article  PubMed  CAS  Google Scholar 

  2. Sala A, Mattano LA Jr, Barr RD (2007) Osteonecrosis in children and adolescents with cancer—An adverse effect of systemic therapy. Eur J Cancer 43:683–689

    Article  PubMed  Google Scholar 

  3. Mont MA, LaPorte D, Jones LC (1999) Symptomatic multifocal osteonecrosis. A multicenter study. Collaborative Osteonecrosis Group. Clin Orthop Relat Res 369:312–326

    Article  Google Scholar 

  4. Aricò M, Boccalatte MF, Silvestri D et al (2003) Osteonecrosis: An emerging complication of intensive chemotherapy for childhood acute lymphoblastic leukemia. Haematologica 88:747–753

    PubMed  Google Scholar 

  5. Raab P, Kuhl J, Krauspe R (1997) Multifocal osteonecrosis in children and adolescents after polychemotherapy. Z Orthop Ihre Grenzgeb 135:444–450

    Article  PubMed  CAS  Google Scholar 

  6. Wei SY, Esmail AN, Bunin N, Dormans JP (2000) Avascular necrosis in children with acute lymphoblastic leukemia. J Pediatr Orthop 20:331–335

    Article  PubMed  CAS  Google Scholar 

  7. Mattano LA Jr, Sather HN, Trigg ME, Nachman JB (2000) Osteonecrosis as a complication of treating acute lymphoblastic leukemia in children: A report from the Children’s Cancer Group. J Clin Oncol 18:3262–3272

    PubMed  Google Scholar 

  8. Ojala AE, Paakko E, Lanning FP, Lanning M (1999) Osteonecrosis during the treatment of childhood acute lymphoblastic leukemia: A prospective MRI study. Med Pediatr Oncol 32:11–17

    Article  PubMed  CAS  Google Scholar 

  9. Atsumi T, Kuroki Y (1992) Role of impairment of blood supply of the femoral head in the pathogenesis of idiopathic osteonecrosis. Clin Orthop Relat Res 277:22–30

    PubMed  Google Scholar 

  10. Mont MA, Jones LC, Hungerford DS (2006) Nontraumatic osteonecrosis of the femoral head: Ten years later. J Bone Joint Surg 88:1117–1132

    Article  PubMed  Google Scholar 

  11. Warwick BJ, Caristo V, Hartin N et al (2006) MRI-negative, bone scintigram-positive in early osteonecrosis of the knees. Clin Nucl Med 31:750–753

    Article  PubMed  Google Scholar 

  12. Karimova EJ, Rai SN, Howard SC et al (2007) Femoral head osteonecrosis in pediatric and young adult patients with leukemia or lymphoma. J Clin Oncol 25:1525–1531

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. 1st Orthopedic Department, Policlinico di Bari, Piazza G. Cesare 11, 70124, Bari, Italy

    Giuseppe Solarino, Lorenzo Scialpi, Marco Bruno & Berenice De Cillis

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  1. Giuseppe Solarino
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  2. Lorenzo Scialpi
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  3. Marco Bruno
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  4. Berenice De Cillis
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Correspondence to Giuseppe Solarino.

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Solarino, G., Scialpi, L., Bruno, M. et al. On a case of multifocal osteonecrosis in a patient suffering from acute lymphoblastic leukemia. Chir Organi Mov 92, 119–122 (2008). https://doi.org/10.1007/s12306-008-0047-2

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  • DOI: https://doi.org/10.1007/s12306-008-0047-2

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