The incidence, risk factors, and outcomes of symptomatic avascular necrosis of bone among Chinese pediatric patients with acute lymphoblastic leukemia

Background Avascular necrosis (AVN) of bone is a debilitating complication of pediatric patients with acute lymphoblastic leukemia (ALL). While it is extensively studied and reported in Western population, studies focused on Orientals are limited. This study aims to evaluate the incidence, risk fact...

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Bibliographic Details
Published in:Cancer medicine (Malden, MA) MA), 2023-05, Vol.12 (9), p.10315-10325
Main Authors: Hoo, Calvin Pui Lun, Leung, Alex Wing Kwan, Chan, Joyce Pui Kwan, Cheung, Yin Ting, Cheng, Frankie Wai Tsoi, Chow, Terry Tin Wai, Lam, Grace Kee See, Ha, Sau Yin, Chiang, Alan Kwok Shing, Li, Rever Chak Ho, Li, Chi Kong
Format: Article
Language:English
Subjects:
Activities of Daily Living
Acute lymphoblastic leukemia
Adolescent
Age
Avascular necrosis
Cancer
Child
Children & youth
Clinical outcomes
Cohort Studies
Drug dosages
East Asian People
Hip
Humans
Incidence
Leukemia
Lymphatic leukemia
Magnetic resonance imaging
Necrosis
osteonecrosis
Osteonecrosis - complications
Osteonecrosis - etiology
Pain
Pain - etiology
Patients
Pediatrics
Population studies
Precursor Cell Lymphoblastic Leukemia-Lymphoma - complications
Precursor Cell Lymphoblastic Leukemia-Lymphoma - epidemiology
Precursor Cell Lymphoblastic Leukemia-Lymphoma - therapy
precursor cell lymphoblastic leukemia‐lymphoma
Retrospective Studies
Risk Factors
Steroids
young adult
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Summary:Background Avascular necrosis (AVN) of bone is a debilitating complication of pediatric patients with acute lymphoblastic leukemia (ALL). While it is extensively studied and reported in Western population, studies focused on Orientals are limited. This study aims to evaluate the incidence, risk factors, and clinical outcomes of AVN among Chinese children with ALL. Methods This study is a retrospective, territory‐wide population‐based cohort study of pediatric patients with ALL enrolled on one of the three consecutive ALL study protocols (ALL‐IC‐BFM 2002, CCLG‐ALL 2008, and CCCG‐ALL 2015). Results A total of 24 out of 533 pediatric subjects with ALL (4.5%) had symptomatic AVN. Age was the single most important risk factor associated with the development of AVN. Only three patients were below age of 10 at the time of diagnosis of ALL. The incidences of AVN in patients aged above and below 10 years were 18.2% ± 3.6% and 0.8% ± 0.5%, respectively, and were significantly different (p 
ISSN:2045-7634
2045-7634
DOI:10.1002/cam4.5762