Radiological follow-up of osteonecrosis lesions in children and adolescents with Hodgkin lymphoma.

Autor: Aarnivala H; Department of Pediatrics, Oulu University Hospital, Oulu, Finland.; Research Unit of Clinical Medicine, University of Oulu, Oulu, Finland., Giertz M; Department of Pediatric Oncology and Hematology, Uppsala University Hospital, Uppsala, Sweden.; Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden., Michelsen SW; Department of Pediatric and Adolescence Medicine, Clinic for Pediatric Oncology and Hematology, University Hospital Rigshospitalet, Copenhagen, Denmark., Björklund C; Department of Pediatric Hematology and Oncology, Umeå University Hospital, Umeå, Sweden., Englund A; Department of Pediatric Oncology and Hematology, Uppsala University Hospital, Uppsala, Sweden.; Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden., Grönroos M; Department of Pediatrics, Turku University Hospital, Turku, Finland., Hjalgrim LL; Department of Pediatric and Adolescence Medicine, Clinic for Pediatric Oncology and Hematology, University Hospital Rigshospitalet, Copenhagen, Denmark., Huttunen P; Department of Pediatric Hematology, Oncology and Stem Cell Transplantation, New Children's Hospital, Helsinki University Hospital, Helsinki, Finland., Niinimäki T; Research Unit of Clinical Medicine, University of Oulu, Oulu, Finland.; Department of Surgery, Oulu University Hospital, Oulu, Finland., Penno E; Department of Diagnostic Radiology, Uppsala University Hospital, Uppsala, Sweden., Pokka T; Research Service Unit, Oulu University Hospital, Oulu, Finland., Pöyhönen T; Department of Pediatrics, Kuopio University Hospital, Kuopio, Finland., Raittinen P; Centre for Child Health Research, Tampere University and University Hospital, Tampere, Finland., Ranta S; Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden.; Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden., Svahn JE; Department of Pediatric Oncology, Skåne University Hospital, Lund University, Lund, Sweden., Törnudd L; Department of Pediatrics, Linköping University Hospital, Linköping, Sweden., Harila A; Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden., Niinimäki R; Department of Pediatrics, Oulu University Hospital, Oulu, Finland.; Research Unit of Clinical Medicine, University of Oulu, Oulu, Finland.
Jazyk: angličtina
Zdroj: British journal of haematology [Br J Haematol] 2024 Oct; Vol. 205 (4), pp. 1460-1468. Date of Electronic Publication: 2024 Aug 03.
DOI: 10.1111/bjh.19687
Abstrakt: Osteonecrosis (ON) is a common complication of glucocorticoid-based Hodgkin lymphoma (HL) treatment, but the natural evolution and prognosis of ON lesions remain poorly understood. We describe the radiological evolution of ON lesions identified in a Nordic population-based cohort of paediatric HL patients. Magnetic resonance images of suspected ON lesions were centrally reviewed to confirm ON diagnosis and grade the ON lesions according to the Niinimäki classification. The study included 202 ON lesions in 46 patients, of which 77 were joint lesions. Follow-up images were available for 146/202 lesions, with a mean follow-up time of 28 months. During follow-up, 71% of the lesions remained stable, 26% improved or resolved, and 3% progressed. A higher ON grade at diagnosis was associated with a lower likelihood of spontaneous resolution. The likelihood for resolution of ON decreased by 50% for each year of added patient age, when adjusted for sex, ON location, and symptoms. Hip ON showed less spontaneous improvement compared with other joints, and the risk for surgery was 13-fold in hip ON. Grades 3-4 joint ON has the potential to either progress or resolve, warranting follow-up in patients with severe symptoms. Research on secondary prevention should be directed at grade 3-4 joint ON.
(© 2024 The Author(s). British Journal of Haematology published by British Society for Haematology and John Wiley & Sons Ltd.)
Databáze: MEDLINE
Externí odkaz: