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Article Dans Une Revue Biology of Blood and Marrow Transplantation Année : 2014

Avascular necrosis of bone after allogeneic hematopoietic cell transplantation in children and adolescents.

Xiaxin Li
  • Fonction : Auteur
Ruta Brazauskas
  • Fonction : Auteur
Zhiwei Wang
Amal Al-Seraihy
  • Fonction : Auteur
K Scott Baker
  • Fonction : Auteur
Jean-Yves Cahn
  • Fonction : Auteur
Haydar A Frangoul
  • Fonction : Auteur
James L Gajewski
  • Fonction : Auteur
Gregory A Hale
  • Fonction : Auteur
Jack W Hsu
  • Fonction : Auteur
Rammurti T Kamble
  • Fonction : Auteur
Hillard M Lazarus
  • Fonction : Auteur
David I Marks
Richard T Maziarz
  • Fonction : Auteur
Bipin N Savani
  • Fonction : Auteur
Ami J Shah
  • Fonction : Auteur
Nirali Shah
  • Fonction : Auteur
Mohamed L Sorror
  • Fonction : Auteur
William A Wood
  • Fonction : Auteur
Navneet S Majhail
  • Fonction : Auteur

Résumé

We conducted a nested case-control study within a cohort of 6244 patients to assess risk factors for avascular necrosis (AVN) of bone in children and adolescents after allogeneic transplantation. Eligible patients were ≤21 years of age, received their first allogeneic transplant between 1990 and 2008 in the United States, and had survived ≥ 6 months from transplantation. Overall, 160 patients with AVN and 478 control subjects matched by year of transplant, length of follow-up and transplant center were identified. Patients and control subjects were confirmed via central review of radiology, pathology, and/or surgical procedure reports. Median time from transplant to diagnosis of AVN was 14 months. On conditional logistic regression, increasing age at transplant (≥5 years), female gender, and chronic graft-versus-host disease (GVHD) were significantly associated with increased risks of AVN. Compared with patients receiving myeloablative regimens for malignant diseases, lower risks of AVN were seen in patients with nonmalignant diseases and those who had received reduced-intensity conditioning regimens for malignant diseases. Children at high risk for AVN include those within the age group where rapid bone growth occurs as well as those who experience exposure to myeloablative conditioning regimens and immunosuppression after hematopoietic cell transplantation for the treatment of GVHD. More research is needed to determine whether screening strategies specifically for patients at high risk for developing AVN with early interventions may mitigate the morbidity associated with this complication.

Domaines

Immunité innée

Dates et versions

hal-00979446 , version 1 (16-04-2014)

Identifiants

Citer

Xiaxin Li, Ruta Brazauskas, Zhiwei Wang, Amal Al-Seraihy, K Scott Baker, et al.. Avascular necrosis of bone after allogeneic hematopoietic cell transplantation in children and adolescents.. Biology of Blood and Marrow Transplantation, 2014, 20 (4), pp.587-92. ⟨10.1016/j.bbmt.2013.12.567⟩. ⟨hal-00979446⟩
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