title: Prevalence of osteonecrosis and associated risk factors in children before allogeneic BMT.
abstract: Osteonecrosis (ON) is a debilitating long-term complication of allogeneic BMT (allo-BMT), but may begin before allo-BMT in some children because of their primary disease treatment. Therefore, to estimate the prevalence and associated risk factors for ON before allo-BMT, we conducted a retrospective analysis of magnetic resonance (MR) studies of 118 children who underwent first allo-BMT at our institution between December 2000 and September 2007. Of the 118 consecutive patients, 107 (90.7%) underwent prospective MR studies irrespective of symptoms (69 males; median age at allo-BMT 12.9 years), and 11 underwent MR studies for symptoms. Among the 107 who had prospective imaging, 23 (21.5%) had ON; nearly 50% had at least 30% epiphyseal involvement. Knees were more frequently involved than were hips; severity of ON was greater in hips. ON prevalence before allo-BMT was 23.72% when all 118 patients were included in the denominator. Risk factor analysis, limited to MR studies performed irrespective of symptoms, revealed female gender (P=0.049) and age 10 years at the time of MR study (P=0.03) as significant risk factors, and primary diagnosis of lymphoid malignancies and aplastic anemia trended toward significance. ON before allo-BMT is a common occurrence in children.
authors.affiliation: Department of Radiological Sciences, St. Jude Children's Research Hospital, Memphis, TN 38105-2794, USA.
authors.forename: S
authors.initials: S
authors.lastname: Sharma
authors.forename: S
authors.initials: S
authors.lastname: Yang
authors.forename: R
authors.initials: R
authors.lastname: Rochester
authors.forename: L
authors.initials: L
authors.lastname: Britton
authors.forename: W H
authors.initials: WH
authors.lastname: Leung
authors.forename: J
authors.initials: J
authors.lastname: Yang
authors.forename: M D
authors.initials: MD
authors.lastname: Neel
authors.forename: K K
authors.initials: KK
authors.lastname: Ness
authors.forename: S C
authors.initials: SC
authors.lastname: Kaste
mesh_terms: D000293:Adolescent; D000367:Age Factors; D000741:Anemia, Aplastic / Q000628:therapy; D016026:Bone Marrow Transplantation; D002648:Child; D002675:Child, Preschool; D005260:Female; D006615:Hip; D006801:Humans; D007223:Infant; D007717:Knee; D007945:Leukemia, Lymphoid / Q000628:therapy; D008279:Magnetic Resonance Imaging; D008297:Male; D010020:Osteonecrosis / Q000453:epidemiology*; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D013997:Time Factors; D014184:Transplantation, Homologous; D055815:Young Adult
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