Evidence map›Paper›PMID 40781902›Full record

ArticleBritish journal of haematology2025

Follow-up of osteonecrosis in paediatric acute lymphoblastic leukaemia patients treated with the NOPHO ALL2008 protocol.

Roosa Rokkanen, Henri Aarnivala, Sanna Huhtaniska, Sauli Palmu, Tytti Pokka, Tuuli Pöyhönen, Maria Suo-Palosaari, Pauliina Utriainen, Liisa Järvelä, Riitta Niinimäki

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in British journal of haematology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Roosa RokkanenResearch Unit of Clinical Medicine, University of Oulu, Oulu, Finland.ORCID https://orcid.org/0000-0002-9879-0527
Henri AarnivalaResearch Unit of Clinical Medicine, University of Oulu, Oulu, Finland.ORCID https://orcid.org/0000-0002-2025-3676
Sanna HuhtaniskaDepartment of Diagnostic Radiology, Oulu University Hospital and Research Unit of Medical Imaging, Physics, and Technology Medical Research Center Oulu, University of Oulu, Oulu, Finland.
Sauli PalmuTampere Center for Child, Adolescent and Maternal Health Research, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.
Tytti PokkaResearch Service Unit, Oulu University Hospital, Oulu, Finland.
Tuuli PöyhönenDepartment of Pediatrics, Kuopio University Hospital, Kuopio, Finland.
Maria Suo-PalosaariDepartment of Diagnostic Radiology, Oulu University Hospital and Research Unit of Medical Imaging, Physics, and Technology Medical Research Center Oulu, University of Oulu, Oulu, Finland.
Pauliina UtriainenDepartment of Paediatric Hematology, Oncology and Stem Cell Transplantation, Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Liisa JärveläDepartment of Paediatrics and Adolescent Medicine, Turku University Hospital and University of Turku, Turku, Finland.
Riitta NiinimäkiResearch Unit of Clinical Medicine, University of Oulu, Oulu, Finland.

Funding

Finnish State Research Funding granted by the Ministry of Social Affairs and HealthPaediatric Cancer Foundation AamuThe Snellman FoundationVäre Foundation for Paediatric Cancer Research
6 · The paper itself

Abstract

Although osteonecrosis (ON) is a common sequel after childhood acute lymphoblastic leukaemia treatment and may cause debilitating symptoms, its prognosis remains underexplored. We describe the radiological evolution of ON lesions in a Finnish patient cohort treated according to the The Nordic Society of Paediatric Haematology and Oncology (NOPHO) ALL2008 protocol. We aimed to identify the factors influencing the outcome of ON. We collected data from 37 patients diagnosed with ON treated in five tertiary centres. We analysed magnetic resonance imaging scans containing 235 ON lesions (109 affecting joints) and graded them using the Niinimäki classification system. The mean follow-up time from an ON diagnosis was 3.3 years (SD 3.4 range: 0.04-13.5). Among the lesions with follow-up scans, 55% remained stable, 35% resolved, 8% improved to lower grade and 2% progressed. Joint collapse was observed in 18 joint lesions (17%). Factors associated with unfavourable outcomes were female sex, older age at diagnosis and haematopoietic stem cell transplantation (HSCT). The chance for spontaneous resolution of ON was lower in females (adjusted odds ratio [aOR] 10.3, 95% CI 2.0-52.6) and decreased with age (aOR 1.4, 95% CI 1.1-1.7), whereas HSCT was associated with joint collapse already at ON diagnosis (aOR 8.3, 95% CI 2.6-27.0).

Indexed as

Antineoplastic Combined Chemotherapy ProtocolsOsteonecrosisPrecursor Cell Lymphoblastic Leukemia-LymphomaAdolescentChildChild, PreschoolFemaleFinlandFollow-Up StudiesHematopoietic Stem Cell TransplantationHumansInfantMagnetic Resonance ImagingMaleacute lymphoblastic leukaemiachildrenmagnetic resonance imagingosteonecrosis

Identifiers

PMID40781902
PMCPMC12624161

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.