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Repeats in the kringle IV encoding domains in the Apo(a) gene and serum lipoprotein(a) level do not contribute to the risk for avascular necrosis of the bone (AVN) in pediatric acute lymphoblastic leukemia

Leukemia volume 20, pages 879–880 (2006)Cite this article

Avascular necrosis of the bone (AVN) or osteonecrosis is a potentially disabling complication of the treatment of childhood ALL. The reported incidence of symptomatic AVN in pediatric ALL is 4–12.5% with a higher incidence in older children.1 AVN mostly affects the weight bearing joints resulting in progressive joint damage, sometimes necessitating total joint replacement. Symptoms consist of pain, limited range of motion, limping, joint destruction following bone collapse and arthritis.

The pathogenesis of AVN is multifactorial. In ALL patients the use of corticosteroids and methotrexate is thought to contribute to the development of AVN.2 However, the difference in the occurrence and severity of symptomatic AVN between pediatric ALL patients treated according to one and the same treatment protocol suggests differences in susceptibility based on genetic variation.

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Acknowledgements

The authors thank Professor Dr G Utermann for providing the apo(a) probe and Dr B Leeuw from the UMC Groningen, Department of Pediatric Oncology for providing us data from one patient.

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Authors and Affiliations

  1. Department of Pediatric Oncology/Hematology, Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands

    R D van Beek, D D L Bezemer, J P P Meijerink, L te Winkel, R Pieters & M van den Heuvel-Eibrink

  2. Department of Pediatric Endocrinology, Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands

    R D van Beek & S M P F de Muinck Keizer-Schrama

  3. Children's Cancer Research institute, Vienna, Austria

    O A Haas

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  1. R D van Beek
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van Beek, R., Bezemer, D., Meijerink, J. et al. Repeats in the kringle IV encoding domains in the Apo(a) gene and serum lipoprotein(a) level do not contribute to the risk for avascular necrosis of the bone (AVN) in pediatric acute lymphoblastic leukemia. Leukemia 20, 879–880 (2006). https://doi.org/10.1038/sj.leu.2404161

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