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An already selected group of childhood ALL survivors who experienced symptomatic osteonecrosis during or shortly after discontinuation of treatment (according to the DCOG ALL-9, 10, 11 or the EsPhALL treatment protocols).
The goal of this study is to gain insight in the long-term outcome of symptomatic osteonecrosis in childhood ALL survivors who have experienced symptomatic osteonecrosis during or shortly after discontinuation of treatment. Currently, it is difficult to inform patients that suffer from osteonecrosis about their future prospects. We hope that the information acquired in this study will help us to better inform these children in the future.
The survival rate of children with acute lymphoblastic leukemia (ALL) has substantially improved over the past decades. As ALL treatment may be accompanied by toxicity, insights in long-term sequelae among childhood ALL survivors have become increasingly important.
Osteonecrosis is a debilitating osteogenic side-effect that can occur during or shortly after discontinuation of ALL treatment, caused by temporary or permanent loss of the blood supply to mainly weight-bearing bones. Previous research has shown that 60% of the patients with symptomatic osteonecrosis experienced symptoms after several years. However, the proportion of patients that remain symptomatic or that develop osteonecrosis-related morbidity on the long-term remains unclear. This makes it difficult to inform patients that currently suffer from osteonecrosis about their future prospects.