Patel B, Richards S M, Rowe J M, Goldstone A H, Fielding A K
Department of Haematology, Royal Free and University College Medical School, London, UK.
Leukemia. 2008 Feb;22(2):308-12. doi: 10.1038/sj.leu.2405032. Epub 2007 Nov 8.
Avascular necrosis (AVN) is a serious complication of acute lymphoblastic leukaemia (ALL) therapy. Little is known of the scope and magnitude of this problem among adults with ALL. We analysed the incidence and risk factors for AVN in 1053 patients on the UKALLXII/ECOG2993 study. AVN affected 99 joints in 42 patients at a median of 2.2 years post-diagnosis, giving a crude incidence rate of 4.0%. Statistically significant risk factors for the development of AVN were age and treatment with chemotherapy. Patients receiving prolonged chemotherapy without stem cell transplant were at significantly greater risk of developing AVN than stem cell transplant recipients (P<0.00005). The actuarial incidence of AVN was 29% at 10 years in patients <20 years old compared to 8% at 10 years in those >20 years old; P=0.0004; odds ratio 0.28 (95% CI=0.14-0.56).
无血管性坏死（AVN）是急性淋巴细胞白血病（ALL）治疗的一种严重并发症。在成年ALL患者中，对于这个问题的范围和严重程度了解甚少。我们在UKALLXII/ECOG2993研究中分析了1053例患者发生AVN的发生率及危险因素。AVN累及42例患者的99个关节，诊断后中位时间为2.2年，粗发病率为4.0%。发生AVN的统计学显著危险因素为年龄和化疗治疗。接受长期化疗而未进行干细胞移植的患者发生AVN的风险显著高于干细胞移植受者（P<0.00005）。<20岁患者10年时AVN的精算发病率为29%，而>20岁患者10年时为8%；P=0.0004；比值比0.28（95%CI=0.14-0.56）。
