ArticleHaematologica2013
Symptomatic osteonecrosis in childhood leukemia survivors: prevalence, risk factors and impact on quality of life in adulthood.
Article in Haematologica, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 50 papers.
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Who cites it
50 citing papers in PubMed, 100 citations in OpenAlex.
- Ankle osteonecrosis in fifty-one children and adolescent's leukemia survivors: a prospective randomized study on percutaneous mesenchymal stem cells treatment.International orthopaedics · 2021Trial
- Corticosteroid-associated osteonecrosis in paediatric compared with adult patients: are they the same disease?Bone & joint open · 2026Article
- Overall Good Quality of Life Reported by Survivors of Childhood Hodgkin Lymphoma in Sweden and Finland.Acta paediatrica (Oslo, Norway : 1992) · 2026Article
- Treatment for primary avascular necrosis of the lower limb in childhood.The Cochrane database of systematic reviews · 2026Article
- A Novel Murine Model to Study the Early Biological Events of Corticosteroid-Associated Osteonecrosis of the Femoral Head.Bioengineering (Basel, Switzerland) · 2026Article
- Article
- Four Pharmacogenomic Variants Strongly Linked to Corticosteroid-Induced Avascular Necrosis in Children with Cancer.Journal of clinical pharmacology · 2025Article
- Follow-up of osteonecrosis in paediatric acute lymphoblastic leukaemia patients treated with the NOPHO ALL2008 protocol.British journal of haematology · 2025Article
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- Article
- Bone Remodeling in Children with Acute Lymphoblastic Leukemia: A Two-Year Prospective Longitudinal Study.International journal of molecular sciences · 2025Article
- Prevalence of Osteonecrosis in Survivors of Childhood Acute Lymphoblastic Leukaemia of Indian Ethnicity Treated with BFM Protocol.Indian journal of hematology & blood transfusion : an official journal of Indian Society of Hematology and Blood Transfusion · 2025Article
- Temporomandibular Joint and Dental Complications in Long-Term Survivors of Children with Leukemia after Chemoradiotherapy and Stem Cell Transplantation.Indian journal of hematology & blood transfusion : an official journal of Indian Society of Hematology and Blood Transfusion · 2025Article
- Patient-reported outcomes of treatment and adverse effects following acute lymphoblastic leukemia: a low- and middle-income country cross-sectional study.Hematology, transfusion and cell therapy · 2024Article
- Incidence and prevalence of musculoskeletal health conditions in survivors of childhood and adolescent cancers: A report from the Swiss childhood cancer survivor study.Cancer medicine · 2024Article
- The incidence, risk factors, and outcomes of symptomatic avascular necrosis of bone among Chinese pediatric patients with acute lymphoblastic leukemia.Cancer medicine · 2023Article
- Article
- Extensive Osteonecrosis After Glucocorticoids: Clinical Response to Bisphosphonate.JCEM case reports · 2023Article
- [Osteonecrosis-severe side effect of treatment for acute lymphoblastic leukemia].Orthopadie (Heidelberg, Germany) · 2022Review
- Selective Ulnar Nerve Decompression, Capsular Branch Denervation, and Arthroscopic Debridement as a Unique Technique to Improve Quality of Life for Avascular Necrosis of the Distal Humerus and Radius in a Young Patient With ALL.Hand (New York, N.Y.) · 2022Article
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Authors and funding
15 authors at 5 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
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<0.001). A higher cumulative steroid dose, age over ten years at diagnosis, and treatment with transplantation significantly increased the risk of osteonecrosis. A higher post-transplant steroid dose and age over ten years at time of transplantation were significant factors in the transplanted group. With patients grouped according to steroid dose quartile, cumulative incidence of osteonecrosis reached 3.8% in the chemotherapy group for a dose beyond 5835 mg/m(2) and 23.8% after transplantation for a post-transplant dose higher than 2055 mg/m(2). Mean physical composite score of Quality of Life was 44.3 in patients with osteonecrosis versus 54.8% in patients without (P<0.001). We conclude that total and post-transplant cumulative steroid dose may predict the risk of osteonecrosis, a rare late effect with a strong negative impact on physical domains of Quality of Life.
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