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Osteonecrosis in Korean Paediatric and Young Adults with Acute Lymphoblastic Leukaemia or Lymphoblastic Lymphoma: A Nationwide Epidemiological Study

 Seung Min Hahn  ;  Myeongjee Lee  ;  Aaron Huser  ;  Yeonji Gim  ;  Eun Hwa Kim  ;  Minsoo Kim  ;  Amaal M Aldosari  ;  Inkyung Jung  ;  Yoon Hae Kwak 
 JOURNAL OF CLINICAL MEDICINE, Vol.11(9) : 2489, 2022-04 
Journal Title
Issue Date
Republic of Korea ; acute lymphoblastic leukemia ; adolescent and young adult ; lymphoblastic lymphoma ; osteonecrosis
Osteonecrosis (ON) is a serious complication of acute lymphocytic leukaemia (ALL) or lymphoblastic lymphoma (LBL) treatment, and there is little information regarding ON in Korean paediatric and young adult patients. This retrospective cohort study assessed the cumulative incidence of and risk factors for ON using national health insurance claims data from 2008 to 2019 in 4861 ALL/LBL patients. The Kaplan-Meier method was used to estimate the cumulative incidence of ON according to age groups; the Cox proportional hazard regression model was used to identify risk factors related to ON development after diagnosing ALL/LBL. A cause-specific hazard model with time-varying covariates was used to assess the effects of risk factors. Overall, 158 (3.25%) patients were diagnosed with ON, among whom 23 underwent orthopaedic surgeries. Older age, radiotherapy (HR = 2.62, 95% confidence interval (CI) 1.87-3.66), HSCT (HR = 2.40, 95% CI 1.74-3.31), steroid use and anthracycline use (HR = 2.76, CI 1.85-4.14) were related to ON in the univariate analysis. In the multivariate analysis, age and steroid and asparaginase use (HR = 1.99, CI 1.30-3.06) were factors associated with ON. These results suggest that Korean patients with ALL/LBL who used steroids and asparaginase should be closely monitored during follow-up, even among young adult patients.
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1. College of Medicine (의과대학) > Dept. of Biomedical Systems Informatics (의생명시스템정보학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pediatrics (소아과학교실) > 1. Journal Papers
Yonsei Authors
Lee, Myeongjee(이명지)
Jung, Inkyung(정인경) ORCID logo https://orcid.org/0000-0003-3780-3213
Hahn, Seung Min(한승민) ORCID logo https://orcid.org/0000-0001-9832-6380
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