The development of thromboembolism may increase the risk of osteonecrosis in children with acute lymphoblastic leukemia.
Previous studies indicate pathophysiological and epidemiological parallels between osteonecrosis (ON) and thromboembolism (TE), two common treatment-related morbidities in acute lymphoblastic leukemia (ALL). To elucidate risk factors for ON and explore the relationship between ON and TE, we undertook a retrospective study of children (n = 208) with ALL. Twenty-one (10.1%) children developed ON and 42 (20.2%) TE on therapy. Thromboembolism was a significant predictor of ON on univariate (OR 8.85) and multivariate analysis, along with older age and PEGylated asparaginase. This observation supports a role for hypercoagulability in the pathogenesis of ON. Larger prospective studies are needed to further test these findings.
Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada.
Jetan H
JH
Badhiwala
Division of Hematology-Oncology, McMaster Children's Hospital, Hamilton Health Sciences, Hamilton, Ontario, Canada.
Trishana
T
Nayiager
Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada.|Division of Hematology-Oncology, McMaster Children's Hospital, Hamilton Health Sciences, Hamilton, Ontario, Canada.|Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada.
Uma H
UH
Athale
D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D010020:Osteonecrosis / Q000453:epidemiology / Q000209:etiology*; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications / Q000188:drug therapy*; D012189:Retrospective Studies; D012307:Risk Factors; D013923:Thromboembolism / Q000453:epidemiology / Q000209:etiology*
acute lymphoblastic leukemia; oncology; osteonecrosis; pediatrics; thrombosis