Symptomatic osteonecrosis in childhood leukemia survivors: prevalence, risk factors and impact on quality of life in adulthood
Pauline Girard,
Pascal Auquier,
Vincent Barlogis,
Audrey Contet,
Maryline Poiree,
François Demeocq,
Julie Berbis,
Iris Herrmann,
Virginie Villes,
Nicolas Sirvent,
Justyna Kanold,
Pascal Chastagner,
Hervé Chambost,
Dominique Plantaz,
Gérard Michel
Affiliations
Pauline Girard
Department of Pediatric Hematology-Oncology, APHM, La Timone Hospital, Aix-Marseille University, France;Department of Pediatric Hematology-Oncology, University Hospital of Grenoble, France
Pascal Auquier
Department of Public Health -EA 3279 Research Unit, University Hospital Marseille, Aix-Marseille University, France
Vincent Barlogis
Department of Pediatric Hematology-Oncology, APHM, La Timone Hospital, Aix-Marseille University, France;Department of Public Health -EA 3279 Research Unit, University Hospital Marseille, Aix-Marseille University, France
Audrey Contet
Department of Pediatric Hematology-Oncology, University Hospital of Nancy, France
Maryline Poiree
Department of Pediatric Hematology-Oncology, University Hospital of Nice, France
François Demeocq
Department of Pediatric Hematology-Oncology, CIC Inserm 501, University Hospital of Clermont Ferrand, France
Julie Berbis
Department of Public Health -EA 3279 Research Unit, University Hospital Marseille, Aix-Marseille University, France
Iris Herrmann
Department of Pediatric Hematology-Oncology, APHM, La Timone Hospital, Aix-Marseille University, France
Virginie Villes
Department of Public Health -EA 3279 Research Unit, University Hospital Marseille, Aix-Marseille University, France
Nicolas Sirvent
Department of Pediatric Hematology-Oncology, University Hospital of Montpellier, France
Justyna Kanold
Department of Pediatric Hematology-Oncology, CIC Inserm 501, University Hospital of Clermont Ferrand, France
Pascal Chastagner
Department of Pediatric Hematology-Oncology, University Hospital of Nancy, France
Hervé Chambost
Department of Pediatric Hematology-Oncology, APHM, La Timone Hospital, Aix-Marseille University, France
Dominique Plantaz
Department of Pediatric Hematology-Oncology, University Hospital of Grenoble, France
Gérard Michel
Department of Pediatric Hematology-Oncology, APHM, La Timone Hospital, Aix-Marseille University, France;Department of Public Health -EA 3279 Research Unit, University Hospital Marseille, Aix-Marseille University, France
Corticosteroid can induce osteonecrosis in children with leukemia. Few studies have been designed to assess the influence of a wide range of cumulative steroid dose on this side effect. Prevalence, risk factors of symptomatic osteonecrosis and its impact on adults’ Quality of Life were assessed in 943 patients enrolled in the French “Leucémies de l'Enfant et de l'Adolescent“ (LEA) cohort of childhood leukemia survivors. During each medical visit, data on previous osteonecrosis diagnosis were retrospectively collected. Patients without a history but with suggestive symptoms were investigated with magnetic resonance imaging. The total steroid dose in equivalent of prednisone was calculated for each patient and its effect on osteonecrosis occurrence was studied in multivariate models. Cumulative incidence was 1.4% after chemotherapy alone versus 6.8% after transplantation (P
