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• W2810113917 abstract "Abstract 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 1–45 years, 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 12.1 years and 14.9 years 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 1.0–9.9 years (0.7 years [range: 0.2–2.1]) compared with adolescents (1.8 years [range: 0.3–3.7, P < 0.001]) and adults (2.1 years [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 1.1–9.9 years (HR = 2.4, 95% CI: 0.9–6.2, P = 0.08) or adults aged 19–45 years (HR = 1.1, 95% CI: 0.3–4.0). Age above 10 years 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." @default.
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• W2810113917 date "2018-06-26" @default.
• W2810113917 modified "2023-10-18" @default.
• W2810113917 title "Comparing osteonecrosis clinical phenotype, timing, and risk factors in children and young adults treated for acute lymphoblastic leukemia" @default.
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• W2810113917 doi "https://doi.org/10.1002/pbc.27300" @default.
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