Ten cases of treatment-related osteonecrosis in adults with acute leukemia
10.3760/cma.j.issn.1009-9921.2014.07.007
- VernacularTitle:成年人急性白血病治疗相关骨坏死十例分析
- Author:
Penggang QIAO
;
Yingqi DING
;
Juan ZHOU
;
Hongtao ZHANG
;
Xudong XING
;
Gongjie LI
- Publication Type:Journal Article
- Keywords:
Osteonecrosis;
Leukemia;
Chemotherapy;
MRI;
CT
- From:
Journal of Leukemia & Lymphoma
2014;23(7):405-408
- CountryChina
- Language:Chinese
-
Abstract:
Objective To study the imaging features and possible aetiology of osteonecrosis in adults with acute leukemia.Methods Ten adult patients with acute leukemia for osteonecrosis were reviewed retrospectively.All the lesions were confirmed with MRI.Results Four patients with ALL had accepted chemotherapy contained corticosteroids,two of them were performed HSCT,and one patient suffered GVHD.Six patients with AML had accepted chemotherapy without steroids,five of them were performed HSCT,and four patients suffered GVHD.One patient with AML-M3 had accepted chemotherapy including four courses of ATRA.The mean time between diagnosis of osteonecrosis and leukemia was 25.1 months.Nine cases had multiple lesions,one case had single lesion.The lesions involved femurs,tibias,patellas,iliums,and lumbars.Plain radiographs in six patients can not detect any lesion.Circinal reaction ossification could be detected in CT images of four cases.All the cases had typical feature in MRI.Conclusions In adult leukemia patients,osteonecrosis is a complication after chemotherapy or HSCT.Steroids in chemotherapy protocols or treatment for GVHD,ATRA for APML,chemotherapy-induced direct cytotoxic effect or leukemia itself can be the possible risk factor.For the diagnosis,MRI is the most effective way,and CT features of osteonecrosis in leukemia patients are different from those in non-leukemia patients.
