@article{4ff13b79acdb4e73a766b8e80c19d0e3,
title = "Avascular necrosis of bone after allogeneic hematopoietic cell transplantation in children and adolescents",
abstract = "We conducted a nested case-control study within a cohort of 6244 patients to assess risk factors for avascular necrosis (AVN) of bone in children and adolescents after allogeneic transplantation. Eligible patients were ≤21years of age, received their first allogeneic transplant between 1990 and 2008 in the United States, and had survived ≥ 6months from transplantation. Overall, 160 patients with AVN and 478 control subjects matched by year of transplant, length of follow-up and transplant center were identified. Patients and control subjects were confirmed via central review of radiology, pathology, and/or surgical procedure reports. Median time from transplant to diagnosis of AVN was 14months. On conditional logistic regression, increasing age at transplant (≥5years), female gender, and chronic graft-versus-host disease (GVHD) were significantly associated with increased risks of AVN. Compared with patients receiving myeloablative regimens for malignant diseases, lower risks of AVN were seen in patients with nonmalignant diseases and those who had received reduced-intensity conditioning regimens for malignant diseases. Children at high risk for AVN include those within the age group where rapid bone growth occurs as well as those who experience exposure to myeloablative conditioning regimens and immunosuppression after hematopoietic cell transplantation for the treatment of GVHD. More research is needed to determine whether screening strategies specifically for patients at high risk for developing AVN with early interventions may mitigate the morbidity associated with this complication.",
keywords = "Avascular necrosis, Hematopoietic cell transplantation, Late complications",
author = "Xiaxin Li and Ruta Brazauskas and Zhiwei Wang and Amal Al-Seraihy and Baker, {K. Scott} and Cahn, {Jean Yves} and Frangoul, {Haydar A.} and Gajewski, {James L.} and Hale, {Gregory A.} and Hsu, {Jack W.} and Kamble, {Rammurti T.} and Lazarus, {Hillard M.} and Marks, {David I.} and Maziarz, {Richard T.} and Savani, {Bipin N.} and Shah, {Ami J.} and Nirali Shah and Sorror, {Mohamed L.} and Wood, {William A.} and Majhail, {Navneet S.}",
note = "Funding Information: Financial disclosure: The CIBMTR is supported by Public Health Service Grant/Cooperative Agreement U24-CA76518 from the National Cancer Institute (NCI) , the National Heart, Lung and Blood Institute (NHLBI) , and the National Institute of Allergy and Infectious Diseases; Grant/Cooperative Agreement 5U01HL069294 from the NHLBI and NCI; contract HHSH234200637015 C from the Health Resources and Services Administration; 2 grants ( N00014-06-1-0704 and N00014-08-1-0058 ) from the Office of Naval Research ; and grants from Allos, Inc. ; Amgen, Inc. ; Angioblast ; Anonymous donation to the Medical College of Wisconsin; Ariad; Be the Match Foundation; Blue Cross and Blue Shield Association; Buchanan Family Foundation; CaridianBCT; Celgene Corporation; CellGenix, GmbH; Children's Leukemia Research Association; Fresenius-Biotech North America, Inc.; Gamida Cell Teva Joint Venture Ltd.; Genentech, Inc.; Genzyme Corporation; GlaxoSmithKline; HistoGenetics, Inc.; Kiadis Pharma; The Leukemia & Lymphoma Society; The Medical College of Wisconsin; Merck & Co, Inc.; Millennium: The Takeda Oncology Co.; Milliman USA, Inc.; Miltenyi Biotec, Inc.; National Marrow Donor Program; Optum Healthcare Solutions, Inc.; Osiris Therapeutics, Inc.; Otsuka America Pharmaceutical, Inc.; RemedyMD; Sanofi; Seattle Genetics; Sigma-Tau Pharmaceuticals; Soligenix, Inc.; StemCyte, A Global Cord Blood Therapeutics Co.; Stemsoft Software, Inc.; Swedish Orphan Biovitrum; Tarix Pharmaceuticals; Teva Neuroscience, Inc.; THERAKOS, Inc.; and Wellpoint, Inc. The views expressed in this article do not reflect the official policy or position of the National Institutes of Health, the Department of the Navy, the Department of Defense, or any other agency of the U.S. Government. ",
year = "2014",
month = apr,
doi = "10.1016/j.bbmt.2013.12.567",
language = "English (US)",
volume = "20",
pages = "587--592",
journal = "Biology of Blood and Marrow Transplantation",
issn = "1083-8791",
publisher = "Elsevier Inc.",
number = "4",
}