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Acute Leukemias

High incidence of avascular necrosis in adolescents with acute lymphoblastic leukaemia: a UKALL XII analysis

Leukemia volume 22, pages 308–312 (2008)Cite this article

Abstract

Avascular necrosis (AVN) is a serious complication of acute lymphoblastic leukaemia (ALL) therapy. Little is known of the scope and magnitude of this problem among adults with ALL. We analysed the incidence and risk factors for AVN in 1053 patients on the UKALLXII/ECOG2993 study. AVN affected 99 joints in 42 patients at a median of 2.2 years post-diagnosis, giving a crude incidence rate of 4.0%. Statistically significant risk factors for the development of AVN were age and treatment with chemotherapy. Patients receiving prolonged chemotherapy without stem cell transplant were at significantly greater risk of developing AVN than stem cell transplant recipients (P<0.00005). The actuarial incidence of AVN was 29% at 10 years in patients <20 years old compared to 8% at 10 years in those >20 years old; P=0.0004; odds ratio 0.28 (95% CI=0.14–0.56).

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Acknowledgements

AKF is supported by the Leukaemia Research Fund (UK).

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Authors and Affiliations

  1. Department of Haematology, Royal Free and University College Medical School, London, UK

    B Patel & A K Fielding

  2. Clinical Trial Service Unit, Oxford, UK

    S M Richards

  3. Department of Hematology, Rambam Medical Center, Haifa, Israel

    J M Rowe

  4. Technion, Haifa, Israel

    J M Rowe

  5. North London Cancer Network, UCL Hospitals, London, UK

    A H Goldstone

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  1. B Patel
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  2. S M Richards
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  4. A H Goldstone
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  5. A K Fielding
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Correspondence to A K Fielding.

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Patel, B., Richards, S., Rowe, J. et al. High incidence of avascular necrosis in adolescents with acute lymphoblastic leukaemia: a UKALL XII analysis. Leukemia 22, 308–312 (2008). https://doi.org/10.1038/sj.leu.2405032

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