Table 3.
Comparison of osteonecrosis data in pediatric patients with acute lymphocytic leukemia and hematologic malignancies reported in the literature
| Study | Number of patients | Period analyzed | Age range of patients at primary diagnosis (years) (median) | Symptomatic patients only | Imaging modality | Only lower limbs studied | % Diagnosed with ON in maintenance phase of chemotherapy | % With ON (number) | % With multisite ON (number) | Children older than 10 years predominantly affected |
|---|---|---|---|---|---|---|---|---|---|---|
| Strauss et al. [24] | 176 | 1987–1995 | NR | Yes | NR | No | 45 % | 7 (13) | 77 (10) | Yes |
| Mattano et al. [18] | 1409 | 1989–1995 | NR | Yes | MRI and other | No | 54 % | 8 (111) | 74 (82) | Yes |
| Ojala et al. [20] | 28 | 1992–1996 | 1.6–12.8 (8.3) | No | MRI | No | NR | 32 (9) | 89 (8) | No |
| Ojala et al. [21] | 24 | 1991–1996 | 2.1–15.0 (5.9) | No | MRI | Yes* | NR | 24 (9) | 78 (7) | No |
| Burger et al. [2] | 1951 | 1996–2000 | NR | Yes | NR | Yes | 35% | 2 (31) | 64 (20) | Yes |
| Karimova et al. [12] | 302 | 1994–2003 | 1.0–18.8 (10) | No | MRI | Yes | NR | 56 (168) | 80 (135) | Yes |
| Elmantaser et al. [7] | 186 | 1997–2007 | 1.7–13.6 (5.3) | Yes | MRI | No | NR | 10 (18) | 55 (10) | Yes |
| Kawedia et al. [15] | 365 | NR | NR | No | MRI | Yes | 55% | 65 (238) | NR | Yes |
| Beer et al. [1] | 5 | NR | NR | Yes | WB-MRI | No | NR | 80 (4) | 100% (4) | Yes |
| Current study | 11 | 2006–2008 | 4.8–11.9 (5.4) | Yes | WB-MRI | No | 89% | 82 (9) | 100% (9) | No |
ON = osteonecrosis; NR = not reported, WB-MRI = whole-body MRI; *four of 24 patients also had upper limb MRI, with no osteonecrosis of the humeral head detected.