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

Abstract

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.

• Authors: Domenico Albano, Caterina Patti, Ludovico La Grutta, Emanuele Grassedonio, Antonino Mulè, Giuseppe Brancatelli, Roberto Lagalla, Massimo Midiri, Massimo Galia
• Journal: European radiology (Eur Radiol) Vol. 27 Issue 5 Pg. 2129-2136 (May 2017) ISSN: 1432-1084 [Electronic] Germany
• PMID: 27519911 (Publication Type: Journal Article)

Chemical References

• Glucocorticoids
• Bleomycin
• Procarbazine
• Vincristine
• Etoposide
• Doxorubicin
• Cyclophosphamide
• Prednisone

Topics

• Adolescent
• Adult
• Antineoplastic Combined Chemotherapy Protocols (administration & dosage, adverse effects)
• Bleomycin (administration & dosage, adverse effects)
• Cyclophosphamide (administration & dosage, adverse effects)
• Dose-Response Relationship, Drug
• Doxorubicin (administration & dosage, adverse effects)
• Drug Administration Schedule
• Etoposide (administration & dosage, adverse effects)
• Female
• Glucocorticoids (adverse effects, therapeutic use)
• Hodgkin Disease (drug therapy, pathology)
• Humans
• Image Interpretation, Computer-Assisted (methods)
• Incidence
• Magnetic Resonance Imaging (methods)
• Male
• Middle Aged
• Neoplasm Staging
• Osteonecrosis (chemically induced, diagnostic imaging)
• Prednisone (administration & dosage, adverse effects)
• Procarbazine (administration & dosage, adverse effects)
• Retrospective Studies
• Vincristine (administration & dosage, adverse effects)
• Whole Body Imaging (methods)
• Young Adult