What Researchers Did
Doctors in Austria reviewed the medical records of children and teenagers treated for blood cancers to find out how many later developed a bone-death complication called aseptic osteonecrosis and how those cases were managed.
What They Found
This retrospective review of 630 children treated for various cancers between 1990 and 2003 identified 9 patients, all with hematologic malignancies, who developed aseptic osteonecrosis. The median age at cancer diagnosis was 15.8 years, and bone-related symptoms appeared a median of 16 months later (range 6 to 53 months). All 9 patients had previously received corticosteroid therapy. Treatment included limiting weight-bearing, physiotherapy, and pain medication; three of the nine patients also received hyperbaric oxygen therapy combined with the drug iloprost, and one of those three additionally received pamidronate. Symptoms improved in all 9 patients under this conservative approach, but 1 patient still required a bilateral hip replacement and 2 required surgery (arthrotomy with sequestrotomy) after their condition worsened.
Canadian Relevance
No direct Canadian connection identified; this study was conducted in Graz, Austria.
Study Limitations
This was a small, single-center retrospective review of only 9 patients (3 of whom received hyperbaric oxygen), with no control group, so it cannot show whether any specific treatment caused the symptom improvement observed.