Haematologica (Jul 2013)

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

DOI
https://doi.org/10.3324/haematol.2012.081265
Journal volume & issue
Vol. 98, no. 7

Abstract

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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