Radiation-induced bone abnormalities after bone marrow transplantation for childhood leukemia.
OBJECTIVE
To identify bone abnormalities related to total-body irradiation (TBI) in long-term survivors of bone marrow transplantation (BMT) for childhood leukemia.


METHODS
The authors obtained skeletal surveys of 10 survivors of childhood leukemia, ages 5-27 years, who had undergone BMT 7-9 years previously. Pretransplantation "conditioning" regimens were composed of chemotherapy and TBI in doses of 12 or 14.4 Gy.


RESULTS
Of the six survivors who received TBI before age 8 years, five had osteochondromas and three had metaphyseal growth abnormalities. One also had slipped femoral capital epiphysis. Findings in the four remaining patients, who received TBI at ages 12-19 years, were less severe and less clearly related to TBI (mild scoliosis in two cases, avascular necrosis of the femoral condyles in one, and a femoral enchondroma in one).


CONCLUSIONS
Skeletal abnormalities, previously recognized as sequelae of local external-beam irradiation in children, may occur in long-term survivors of BMT who have received TBI. Younger patients appear to be at the greatest risk.
Fletcher
B D
BD
Department of Diagnostic Imaging, St Jude Children's Research Hospital, Memphis, TN 38101.
Crom
D B
DB
Krance
R A
RA
Kun
L E
LE
D000293:Adolescent; D000328:Adult; D001847:Bone Diseases / Q000000981:diagnostic imaging* / Q000209:etiology; D016026:Bone Marrow Transplantation; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007938:Leukemia / Q000628:therapy*; D008297:Male; D009381:Neoplasms, Radiation-Induced / Q000000981:diagnostic imaging; D015831:Osteochondroma / Q000000981:diagnostic imaging / Q000209:etiology; D011832:Radiation Injuries / Q000000981:diagnostic imaging* / Q000209:etiology; D011859:Radiography; D014916:Whole-Body Irradiation / Q000009:adverse effects*