6533b82cfe1ef96bd128ecbb

RESEARCH PRODUCT

Osteonecrosis detected by whole body magnetic resonance in patients with Hodgkin Lymphoma treated by BEACOPP

Roberto LagallaCaterina PattiMassimo MidiriAntonino MulèDomenico AlbanoMassimo GaliaLudovico La GruttaEmanuele GrassedonioGiuseppe Brancatelli

subject

MaleBEACOPPLymphomamedicine.medical_treatmentProcarbazine030218 nuclear medicine & medical imaging0302 clinical medicinePrednisoneAntineoplastic Combined Chemotherapy ProtocolsMedicineWhole Body ImagingEtoposideIncidenceOsteonecrosisGeneral MedicineMiddle AgedHodgkin DiseaseMagnetic Resonance ImagingVincristine030220 oncology & carcinogenesisOsteonecrosiFemaleRadiologymedicine.drugAdultVincristinemedicine.medical_specialtyAdolescentCyclophosphamideDrug Administration ScheduleBleomycinYoung Adult03 medical and health sciencesImage Interpretation Computer-AssistedHumansRadiology Nuclear Medicine and imagingCyclophosphamideGlucocorticoidsNeoplasm StagingRetrospective StudiesDose-Response Relationship Drugbusiness.industrymedicine.diseaseLymphomaABVDDoxorubicinProcarbazinePrednisonebusinessComplicationBEACOPP

description

Objectives: The purpose of our retrospective review of prospectively acquired Whole Body Magnetic Resonance (WB-MRI) scans was to assess the incidence of osteonecrosis in patients who received different chemotherapies. Methods: We evaluated the WB-MRI scans performed on 42 patients with Hodgkin Lymphoma treated by three chemotherapy regimens (6ABVD, 2ABVD + 4BEACOPP, 2ABVD + 8BEACOPP), excluding patients with the main risk factors for osteonecrosis. Results: Six out of seven patients (86 %) who received eight BEACOPP and one out of five patients (20 %) treated by four BEACOPP presented osteonecrosis, with a statistically significant difference of frequency between the two groups of patients (p < 0.05); no injury has been reported in patients treated by only ABVD. Among a total of 48 osteonecrotic lesions observed, 48 % were detected in the knee; multifocal osteonecrosis were detected in six out of seven patients (86 %). Conclusions: The development of osteonecrosis is strictly related to the chemotherapy protocol adopted and the number of cycles received, with a strong correlation between the dose of corticosteroids included in the BEACOPP scheme and this complication. WB-MRI can be considered as a helpful tool that allows detecting earlier osteonecrotic lesions in patients treated with corticosteroids. Key Points: • Osteonecrosis is a possible complication of patients with Lymphoma treated by chemotherapy.• Osteonecrosis is related to the corticosteroids included within the BEACOPP protocol.• WB-MRI allows detecting osteonecrotic lesions in patients treated with corticosteroids.

https://doi.org/10.1007/s00330-016-4535-8