Blauensteiner W, Gadner H, Buch J, Grabner A
St.-Anna-Kinderspital, Wien.
Padiatr Padol. 1987;22(3):251-8.
Four children with leukemia (1.6% of all leukemia patients) treated between 1979 and 1984 developed aseptic bone necroses, all of them at multiple sites. The average time from starting chemotherapy to developing bone necroses has been 19 months (range 9 to 28 months). This is a well known complication of corticoid therapy, but corticoids may not be the only aetiological factor. Other antineoplastic agents and leukemia for itself have been associated with aseptic bone necroses. Bone and joint pain caused by aseptic bone necroses can mimic leukemic relapse, so the diagnosis may be difficult. The increasing number of long term survivors in childhood leukemia, who underwent aggressive polychemotherapy, could make this problem more common in the near future.
1979年至1984年间接受治疗的4名白血病患儿(占所有白血病患者的1.6%)出现了无菌性骨坏死,均为多部位发病。从开始化疗到出现骨坏死的平均时间为19个月(范围9至28个月)。这是皮质类固醇治疗的一种众所周知的并发症,但皮质类固醇可能不是唯一的病因。其他抗肿瘤药物以及白血病本身都与无菌性骨坏死有关。无菌性骨坏死引起的骨和关节疼痛可能会酷似白血病复发,因此诊断可能困难。接受积极联合化疗的儿童白血病长期存活者数量不断增加,这可能使该问题在不久的将来更为常见。