Antineoplastics
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Reactions 707 - 27 Jun 1998 S Antineoplastics Avascular necrosis of bone: 5 case reports Five patients, 3 men and 2 women aged 14–41 years, developed avascular necrosis of bone following antineoplastic therapy for acute lymphoblastic leukaemia (ALL). All of the patients had received corticosteroid therapy with a cumulative dose of 2.9–4 g/m 2 . The patients received induction therapy with vincristine, prednisolone, asparaginase, daunorubicin and methotrexate, followed by reinduction and intensification with cyclophosphamide, cytarabine, vincristine and mercaptopurine [dosages not stated]. They received maintenance therapy with 6 cycles of daily oral mercaptopurine and weekly oral methotrexate with 3 monthly pulses of vincristine, daunorubicin, prednisolone and asparaginase; total duration of treatment 24–30 months. Two of the patients developed painful hip movements with difficulty walking and squatting and the other 3 patients were unable to carry loads because of hip pain. The bone necrosis was bilateral in 3 patients and unilateral in 2 patients. The median time from the diagnosis of ALL until the development of bone necrosis was 29 months. Two patients were still receiving maintenance antineoplastic therapy at the time they developed bone necrosis and received further treatment without corticosteroids. Three patients underwent corrective surgery. [Patient outcomes not stated.] Author comment: ‘The data suggests that patients receiving combination chemotherapy, especially those with high cumulative doses of steroids, run an increased risk of developing AVNB [avascular bone necrosis].’ Vaidya S, et al. Avascular necrosis of bone: a complication of aggressive therapy for acute lymphoblastic leukemia. Acta Oncologica 37: 175-177, No. 2, 1998 - India 800679972 1 Reactions 27 Jun 1998 No. 707 0114-9954/10/0707-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
Transcript of Antineoplastics
Reactions 707 - 27 Jun 1998
SAntineoplastics
Avascular necrosis of bone: 5 case reportsFive patients, 3 men and 2 women aged 14–41 years,
developed avascular necrosis of bone following antineoplastictherapy for acute lymphoblastic leukaemia (ALL). All of thepatients had received corticosteroid therapy with a cumulativedose of 2.9–4 g/m2.
The patients received induction therapy with vincristine,prednisolone, asparaginase, daunorubicin and methotrexate,followed by reinduction and intensification withcyclophosphamide, cytarabine, vincristine andmercaptopurine [dosages not stated]. They receivedmaintenance therapy with 6 cycles of daily oralmercaptopurine and weekly oral methotrexate with 3 monthlypulses of vincristine, daunorubicin, prednisolone andasparaginase; total duration of treatment 24–30 months.
Two of the patients developed painful hip movements withdifficulty walking and squatting and the other 3 patients wereunable to carry loads because of hip pain. The bone necrosiswas bilateral in 3 patients and unilateral in 2 patients. Themedian time from the diagnosis of ALL until the developmentof bone necrosis was 29 months. Two patients were stillreceiving maintenance antineoplastic therapy at the time theydeveloped bone necrosis and received further treatmentwithout corticosteroids. Three patients underwent correctivesurgery. [Patient outcomes not stated.]
Author comment: ‘The data suggests that patients receivingcombination chemotherapy, especially those with highcumulative doses of steroids, run an increased risk ofdeveloping AVNB [avascular bone necrosis].’Vaidya S, et al. Avascular necrosis of bone: a complication of aggressive therapyfor acute lymphoblastic leukemia. Acta Oncologica 37: 175-177, No. 2, 1998 -India 800679972
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Reactions 27 Jun 1998 No. 7070114-9954/10/0707-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
