title: Presentation and outcomes for children with bone marrow necrosis and acute lymphoblastic leukemia: a literature review.
abstract: Bone marrow necrosis is a rare histopathology finding with the majority of cases occurring in the setting of a hematologic malignancy. This article reports a case of diffuse marrow necrosis in a child secondary to acute lymphoblastic leukemia and summarizes the clinical features and outcomes for children with bone marrow necrosis secondary to leukemia from 20 published reports. This review demonstrated that the most common presenting features were bone pain, fever, pancytopenia, and that outcomes were less favorable when compared with those without necrosis. However, contemporary literature suggests that outcomes are similar for children who have bone marrow necrosis secondary to leukemia when compared with overall survival rates for pediatric leukemia.
authors.affiliation: Department of Pediatrics, Duke University Medical Center, Durham, NC 27710, USA. nirmish.shah@duke.edu
authors.forename: Nirmish R
authors.initials: NR
authors.lastname: Shah
authors.forename: Daniel B
authors.initials: DB
authors.lastname: Landi
authors.forename: Susan G
authors.initials: SG
authors.lastname: Kreissman
authors.forename: Evan
authors.initials: E
authors.lastname: Kulbachi
authors.forename: Cassandra
authors.initials: C
authors.lastname: Moran
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001855:Bone Marrow Diseases / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy