Sanjeev Khera, Shijith KP, Rajan Kapoor, Rajiv Kumar, Somali Pattanayak
{"title":"接受 BFM 方案治疗的印度裔儿童急性淋巴细胞白血病幸存者的骨坏死患病率","authors":"Sanjeev Khera, Shijith KP, Rajan Kapoor, Rajiv Kumar, Somali Pattanayak","doi":"10.1007/s12288-024-01861-4","DOIUrl":null,"url":null,"abstract":"<p>There is paucity of data from low-middle income countries (LMIC) on osteonecrosis (ON) in survivors of childhood acute lymphoblastic leukaemia (cALL-survivors). We conducted this study to estimate prevalence of ON in cALL-survivors of Indian ethnicity and factors affecting it. This cross-sectional study enrolled cALL-survivors post completion of treatment. ON was estimated using magnetic resonance imaging of hip joint. Demographic, anthropometric, therapy/disease-related and biochemical/endocrine factors affecting calcium homeostasis were studied in two groups: with and without ON. Total of 61 out of enrolled 87 cALL-survivors with median age 118 months (range:84–283) were analysed after median 12 months (range:1–113) post completion of therapy. Two-third of the cohort was male and 41% were pubertal. 5/61 (8.2%) were found to have asymptomatic and non-traumatic ON. Three ON were grade II and two were grade III as per Niinimaki radiological classification. Cumulative doses (CD) of dexamethasone, glucocorticoids (GCs), L-asparginase, anthracycline and low serum vit D levels were associated with ON. Other demographic factors including age at diagnosis > 10 year, disease-related, therapy-related factors including cranial irradiation and biochemical/endocrine factors were not associated with ON. The median CD of dexamethasone (<i>p</i> = 0.004) and GCs (<i>p</i> = 0.008) were significantly high in group with ON. Median CD of methotrexate(<i>p</i> = 0.051), anthracycline(<i>p</i> = 0.058) and serum vit D levels(<i>p</i> = 0.054) along with serum alkaline phosphatase levels(<i>p</i> = 0.06) had a trend towards significance but were not statistically significant in ON group. Prevalence of ON of hip in our cohort of cALL-survivors was 8.2%. Higher CD of GCs appeared to be the most significant risk factor associated with ON in our cohort.</p>","PeriodicalId":13314,"journal":{"name":"Indian Journal of Hematology and Blood Transfusion","volume":null,"pages":null},"PeriodicalIF":0.9000,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Prevalence of Osteonecrosis in Survivors of Childhood Acute Lymphoblastic Leukaemia of Indian Ethnicity Treated with BFM Protocol\",\"authors\":\"Sanjeev Khera, Shijith KP, Rajan Kapoor, Rajiv Kumar, Somali Pattanayak\",\"doi\":\"10.1007/s12288-024-01861-4\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p>There is paucity of data from low-middle income countries (LMIC) on osteonecrosis (ON) in survivors of childhood acute lymphoblastic leukaemia (cALL-survivors). We conducted this study to estimate prevalence of ON in cALL-survivors of Indian ethnicity and factors affecting it. This cross-sectional study enrolled cALL-survivors post completion of treatment. ON was estimated using magnetic resonance imaging of hip joint. Demographic, anthropometric, therapy/disease-related and biochemical/endocrine factors affecting calcium homeostasis were studied in two groups: with and without ON. Total of 61 out of enrolled 87 cALL-survivors with median age 118 months (range:84–283) were analysed after median 12 months (range:1–113) post completion of therapy. Two-third of the cohort was male and 41% were pubertal. 5/61 (8.2%) were found to have asymptomatic and non-traumatic ON. Three ON were grade II and two were grade III as per Niinimaki radiological classification. Cumulative doses (CD) of dexamethasone, glucocorticoids (GCs), L-asparginase, anthracycline and low serum vit D levels were associated with ON. Other demographic factors including age at diagnosis > 10 year, disease-related, therapy-related factors including cranial irradiation and biochemical/endocrine factors were not associated with ON. The median CD of dexamethasone (<i>p</i> = 0.004) and GCs (<i>p</i> = 0.008) were significantly high in group with ON. Median CD of methotrexate(<i>p</i> = 0.051), anthracycline(<i>p</i> = 0.058) and serum vit D levels(<i>p</i> = 0.054) along with serum alkaline phosphatase levels(<i>p</i> = 0.06) had a trend towards significance but were not statistically significant in ON group. Prevalence of ON of hip in our cohort of cALL-survivors was 8.2%. Higher CD of GCs appeared to be the most significant risk factor associated with ON in our cohort.</p>\",\"PeriodicalId\":13314,\"journal\":{\"name\":\"Indian Journal of Hematology and Blood Transfusion\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.9000,\"publicationDate\":\"2024-09-05\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Indian Journal of Hematology and Blood Transfusion\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s12288-024-01861-4\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Indian Journal of Hematology and Blood Transfusion","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s12288-024-01861-4","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Prevalence of Osteonecrosis in Survivors of Childhood Acute Lymphoblastic Leukaemia of Indian Ethnicity Treated with BFM Protocol
There is paucity of data from low-middle income countries (LMIC) on osteonecrosis (ON) in survivors of childhood acute lymphoblastic leukaemia (cALL-survivors). We conducted this study to estimate prevalence of ON in cALL-survivors of Indian ethnicity and factors affecting it. This cross-sectional study enrolled cALL-survivors post completion of treatment. ON was estimated using magnetic resonance imaging of hip joint. Demographic, anthropometric, therapy/disease-related and biochemical/endocrine factors affecting calcium homeostasis were studied in two groups: with and without ON. Total of 61 out of enrolled 87 cALL-survivors with median age 118 months (range:84–283) were analysed after median 12 months (range:1–113) post completion of therapy. Two-third of the cohort was male and 41% were pubertal. 5/61 (8.2%) were found to have asymptomatic and non-traumatic ON. Three ON were grade II and two were grade III as per Niinimaki radiological classification. Cumulative doses (CD) of dexamethasone, glucocorticoids (GCs), L-asparginase, anthracycline and low serum vit D levels were associated with ON. Other demographic factors including age at diagnosis > 10 year, disease-related, therapy-related factors including cranial irradiation and biochemical/endocrine factors were not associated with ON. The median CD of dexamethasone (p = 0.004) and GCs (p = 0.008) were significantly high in group with ON. Median CD of methotrexate(p = 0.051), anthracycline(p = 0.058) and serum vit D levels(p = 0.054) along with serum alkaline phosphatase levels(p = 0.06) had a trend towards significance but were not statistically significant in ON group. Prevalence of ON of hip in our cohort of cALL-survivors was 8.2%. Higher CD of GCs appeared to be the most significant risk factor associated with ON in our cohort.
期刊介绍:
Indian Journal of Hematology and Blood Transfusion is a medium for propagating and exchanging ideas within the medical community. It publishes peer-reviewed articles on a variety of aspects of clinical hematology, laboratory hematology and hemato-oncology. The journal exists to encourage scientific investigation in the study of blood in health and in disease; to promote and foster the exchange and diffusion of knowledge relating to blood and blood-forming tissues; and to provide a forum for discussion of hematological subjects on a national scale.
The Journal is the official publication of The Indian Society of Hematology & Blood Transfusion.