title: Avascular necrosis of the femoral head with combination therapy.
abstract: Four patients with malignant lymphoma who were treated with multiple courses of combination chemotherapy, consisting of cyclophosphamide, Oncovin, procarbazine, and prednisone (COPP), developed avascular necrosis of the femoral head(s). Disorders usually associated with the development of avascular necrosis were absent. The total prednisone dose received by each patient was small. Avascular necrosis of the femoral head should be considered in the differential diagnosis of bone pain in patients receiving multiple courses of combination chemotherapy.
mesh_terms: D000328:Adult; D000970:Antineoplastic Agents / Q000009:adverse effects*; D003520:Cyclophosphamide / Q000009:adverse effects / Q000627:therapeutic use; D005260:Female; D005270:Femur Head / Q000098:blood supply*; D005271:Femur Head Necrosis / Q000139:chemically induced*; D006689:Hodgkin Disease / Q000188:drug therapy*; D006801:Humans; D008223:Lymphoma / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D011241:Prednisone / Q000009:adverse effects / Q000627:therapeutic use; D011344:Procarbazine / Q000009:adverse effects / Q000627:therapeutic use; D014750:Vincristine / Q000009:adverse effects / Q000627:therapeutic use
chemical_list: D000970:Antineoplastic Agents; D011344:Procarbazine; D014750:Vincristine; D003520:Cyclophosphamide; D011241:Prednisone