Efficiency of iloprost treatment for chemotherapy-associated osteonecrosis after childhood cancer.
BACKGROUND
The risk of developing avascular osteonecrosis (AVN) after chemotherapy is age related and, at up to 17% of all treated patients, relatively high.


METHODS
In a prospective study, 8 patients (4 male, 4 female, 14.3+/-4.9 years old) were treated for symptomatic chemotherapy-associated AVN with intravenous infusion of iloprost. Association Research Circulation Osseus (ARCO) stages I-IV in 37 bones (25 joints) were treated.


RESULTS
Follow-up was 20.8+/-17 months (range: 6-53 months). No serious adverse reactions due to the infusion with iloprost were recorded. Pain levels were lower and functional outcome measured as Harris Hip and Knee Society Scores improved by the latest follow up.


CONCLUSIONS
Our current data confirm the findings of other investigators that healing of advanced stages of AVN is not possible, but that in early stages of AVN, pain relief and an improvement of joint function can be achieved by iloprost.
Jäger
Marcus
M
Department of Orthopedic Surgery, Heinrich-Heine University Medical School, D-40225 Düsseldorf, Germany. Jaeger@med.uni-duesseldorf.de
Zilkens
Christoph
C
Westhoff
Bettina
B
Jelinek
Eva Maria
EM
Kozina
Gordana
G
Krauspe
Rüdiger
R
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002648:Child; D005260:Female; D006689:Hodgkin Disease / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D016285:Iloprost / Q000627:therapeutic use*; D008297:Male; D010020:Osteonecrosis / Q000139:chemically induced / Q000175:diagnosis / Q000188:drug therapy*; D010146:Pain / Q000139:chemically induced / Q000175:diagnosis / Q000188:drug therapy*; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications* / Q000188:drug therapy; D011379:Prognosis; D011446:Prospective Studies; D016896:Treatment Outcome; D014665:Vasodilator Agents / Q000627:therapeutic use*; D055815:Young Adult
D014665:Vasodilator Agents; D016285:Iloprost