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Pediatric Transplants

Prevalence of osteonecrosis and associated risk factors in children before allogeneic BMT

Bone Marrow Transplantation volume 46, pages 813–819 (2011)Cite this article

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Abstract

Osteonecrosis (ON) is a debilitating long-term complication of allogeneic BMT (allo-BMT), but may begin before allo-BMT in some children because of their primary disease treatment. Therefore, to estimate the prevalence and associated risk factors for ON before allo-BMT, we conducted a retrospective analysis of magnetic resonance (MR) studies of 118 children who underwent first allo-BMT at our institution between December 2000 and September 2007. Of the 118 consecutive patients, 107 (90.7%) underwent prospective MR studies irrespective of symptoms (69 males; median age at allo-BMT 12.9 years), and 11 underwent MR studies for symptoms. Among the 107 who had prospective imaging, 23 (21.5%) had ON; nearly 50% had at least 30% epiphyseal involvement. Knees were more frequently involved than were hips; severity of ON was greater in hips. ON prevalence before allo-BMT was 23.72% when all 118 patients were included in the denominator. Risk factor analysis, limited to MR studies performed irrespective of symptoms, revealed female gender (P=0.049) and age ⩾10 years at the time of MR study (P=0.03) as significant risk factors, and primary diagnosis of lymphoid malignancies and aplastic anemia trended toward significance. ON before allo-BMT is a common occurrence in children.

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Acknowledgements

This work was supported in part by Grant number P30 CA-21765 from the National Institutes of Health, a Center of Excellence grant from the State of Tennessee and the American Lebanese Syrian Associated Charities (ALSAC). We also thank Vani J Shanker and Cherise Guess for editing the manuscript, Sandra Gaither for manuscript preparation and the physicians and nursing staff for providing outstanding clinical care to the patients in this study.

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Authors and Affiliations

  1. Department of Radiological Sciences, St Jude Children's Research Hospital, Memphis, TN, USA

    S Sharma & S C Kaste

  2. Department of Biostatistics, St Jude Children's Research Hospital, Memphis, TN, USA

    S Yang & J Yang

  3. Department of Oncology, St Jude Children's Research Hospital, Memphis, TN, USA

    R Rochester, W-H Leung & S C Kaste

  4. Department of Surgery, St Jude Children's Research Hospital, Memphis, TN, USA

    L Britton & M D Neel

  5. Department of Cancer Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, TN, USA

    K K Ness

  6. Department of Radiology, University of Tennessee Health Science Center, Memphis, TN, USA

    S C Kaste

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  1. S Sharma
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Correspondence to S C Kaste.

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Sharma, S., Yang, S., Rochester, R. et al. Prevalence of osteonecrosis and associated risk factors in children before allogeneic BMT. Bone Marrow Transplant 46, 813–819 (2011). https://doi.org/10.1038/bmt.2010.210

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  • DOI: https://doi.org/10.1038/bmt.2010.210

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