Department of Paediatric Oncology, Haematology and Clinical Immunology, Centre for Child and Adolescent Health, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany.
Department for Children and Adolescents, Division for Stem Cell Transplantation and Immunology, University Hospital Frankfurt, Frankfurt am Main, Germany.
Br J Haematol. 2018 Oct;183(1):104-109. doi: 10.1111/bjh.15511. Epub 2018 Jul 20.
Osteonecrosis (ON) was prospectively assessed in 557 children and adolescents in the Berlin-Frankfurt-Münster Stem Cell Transplantation in children with acute lymphoblastic leukaemia 2003 trial. Median age at haematopoietic stem cell transplantation (HSCT) was 10·3 years (range 0·5-26). Cumulative incidence of symptomatic ON (sON) was 9% at 5 years (standard deviation 1%), median time from HSCT to diagnosis of sON was 12·4 months (range 1-126). Multivariate analysis identified age at HSCT [10-15 years vs. <10 years: hazard ratio (HR) 3·73, P = 0·009; >15 years vs. <10 years: HR 5·46, P = 0·001], diagnosis of sON prior to HSCT and chronic graft-versus-host disease (yes versus no: HR 2·696, P = 0·015) as significant independent risk factors for the development of sON.
2003 年柏林-法兰克福-明斯特儿童急性淋巴细胞白血病造血干细胞移植研究前瞻性评估了 557 例儿童和青少年的骨坏死（ON）。造血干细胞移植（HSCT）时的中位年龄为 10.3 岁（范围 0.5-26）。5 年时症状性 ON（sON）的累积发生率为 9%（标准差为 1%），从 HSCT 到 sON 诊断的中位时间为 12.4 个月（范围 1-126）。多变量分析确定 HSCT 时的年龄[10-15 岁与<10 岁：风险比（HR）3.73，P=0.009；>15 岁与<10 岁：HR 5.46，P=0.001]、HSCT 前 sON 的诊断以及慢性移植物抗宿主病（是与否：HR 2.696，P=0.015）是 sON 发展的显著独立危险因素。
