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Titolo:
AVASCULAR NECROSIS OF BONE AFTER ALLOGENEIC BONE-MARROW TRANSPLANTATION - CLINICAL FINDINGS, INCIDENCE AND RISK-FACTORS
Autore:
SOCIE G; SELIMI F; SEDEL L; FRIJA J; DEVERGIE A; BOURDEAU HE; RIBAUD P; GLUCKMAN E;
Indirizzi:
HOP ST LOUIS,SERV GREFFE MOELLE,1 AVE CLAUDE VELLEFAUX F-75475 PARIS 10 FRANCE HOP ST LOUIS,SERV CHIRURG ORTHOPED PARIS FRANCE HOP ST LOUIS,SERV RADIOL PARIS FRANCE
Titolo Testata:
British Journal of Haematology
fascicolo: 3, volume: 86, anno: 1994,
pagine: 624 - 628
SICI:
0007-1048(1994)86:3<624:ANOBAA>2.0.ZU;2-6
Fonte:
ISI
Lingua:
ENG
Soggetto:
SYSTEMIC LUPUS-ERYTHEMATOSUS; VERSUS-HOST DISEASE; CORTICOSTEROID-THERAPY; ISCHEMIC NECROSIS; LEUKEMIA; COMPLICATIONS;
Keywords:
BONE MARROW TRANSPLANTATION; AVASCULAR NECROSIS OF BONE;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
21
Recensione:
Indirizzi per estratti:
Citazione:
G. Socie et al., "AVASCULAR NECROSIS OF BONE AFTER ALLOGENEIC BONE-MARROW TRANSPLANTATION - CLINICAL FINDINGS, INCIDENCE AND RISK-FACTORS", British Journal of Haematology, 86(3), 1994, pp. 624-628

Abstract

In the present study we describe the incidence, clinical course, and management of avascular necrosis of bone following allogeneic bone marrow transplantation, and identify risk factors related to its development. All patients developing avascular necrosis of bone after allogeneic bone marrow transplantation between January 1974 and September 1992were included in the analysis and were studied using the Hopital Saint Louis Bone Marrow Transplant Database and hospital records. 27/727 allogeneic transplant recipients developed avascular necrosis leading to an 8.1% incidence at 5 years, by product limit estimate, ranging from 5% to 11.2%. Symptoms developed 119-1747 d (median 398 d) after transplantation. In these 27 patients a total of 52 joints were affected (mean 1.92 per patient, range 1-7). The hip joint was most often affected (69% of patients). All patients had joint pain that led to diagnosis by means of standard radiographs with or without the help of technetium-99 scans and/or magnetic resonance imaging. All but three patientsreceived steroid therapy for acute graft-versus-host disease. Among 10 factors tested, three were shown to be significantly linked to an increased risk for developing avascular necrosis by multivariate analysis: male gender (relative risk (RR) 4.72, P = 0.002), age older than 16(RR = 3.87, P = 0.004), and acute graft-versus-host disease requiringsteroid therapy (RR = 6.30, P = 0.0002). 10 patients (37%) required joint replacement within 19 months (range 2-42) following diagnosis of avascular necrosis. In conclusion, avascular necrosis of bone is a frequent late complication of allogeneic bone marrow transplantion causing significant morbidity and requiring replacement surgery in one-thirdof affected patients. In this 18-year single-centre survey, older age, male gender and steroid therapy given for acute graft-versus-host disease were shown to independently increase the risk of avascular necrosis of bone.

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Documento generato il 02/07/20 alle ore 22:06:35