Universität zu Köln

Borchmann, Sven, Mueller, Horst, Haverkamp, Heinz ORCID: 0000-0001-6895-4132, Baues, Christian, Markova, Jana, Huettmann, Andreas, Glunz, Axel, Fuchs, Michael, Borchmann, Peter and Engert, Andreas (2019). Symptomatic osteonecrosis as a treatment complication in Hodgkin lymphoma: an analysis of the German Hodgkin Study Group (GHSG). Leukemia, 33 (2). S. 439 - 447. LONDON: NATURE PUBLISHING GROUP. ISSN 1476-5551

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Abstract

The majority of patients with Hodgkin Lymphoma (HL) can be cured with stage and risk adapted treatment today. Therefore, current research focuses on reducing long-term sequelae of treatment. Osteonecrosis (ON) is a severe long-term complication of HL treatment which has so far not been systematically evaluated. Hence, we investigated incidence, risk factors and timing of symptomatic ON in HL patients. Further endpoints included localization, intervention and outcome of ON. We included all qualified HL patients of the randomized German Hodgkin Study Group trials HD10-15 and HD18, recruited between 05/1998 and 07/2014 and aged from 16 to 60 years. Among 11 330 patients, 66 developed symptomatic ON after first-line treatment, 83.3% within three years. The incidence of symptomatic ON was 0.2% in early-stage HL and 1.0% in advanced-stage HL. Logistic regression revealed the total cumulative corticosteroid dose to be a strong risk factor interacting with younger age. Male sex additionally increased the risk of symptomatic ON. The prognostic value of the corresponding logistic regression model was rather high (AUC = 0.78). Other tested potential risk factors including obesity, IPS and radiotherapy did not further increase the risk of ON. Further development of current treatment protocols should aim to reduce the cumulative corticosteroid dose.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Borchmann, Sven UNSPECIFIED UNSPECIFIED UNSPECIFIED Mueller, Horst UNSPECIFIED UNSPECIFIED UNSPECIFIED Haverkamp, Heinz UNSPECIFIED orcid.org/0000-0001-6895-4132 UNSPECIFIED Baues, Christian UNSPECIFIED UNSPECIFIED UNSPECIFIED Markova, Jana UNSPECIFIED UNSPECIFIED UNSPECIFIED Huettmann, Andreas UNSPECIFIED UNSPECIFIED UNSPECIFIED Glunz, Axel UNSPECIFIED UNSPECIFIED UNSPECIFIED Fuchs, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Borchmann, Peter UNSPECIFIED UNSPECIFIED UNSPECIFIED Engert, Andreas UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-158005
DOI:	10.1038/s41375-018-0240-8
Journal or Publication Title:	Leukemia
Volume:	33
Number:	2
Page Range:	S. 439 - 447
Date:	2019
Publisher:	NATURE PUBLISHING GROUP
Place of Publication:	LONDON
ISSN:	1476-5551
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language CANCER-RELATED FATIGUE; OPEN-LABEL; AVASCULAR NECROSIS; FINAL ANALYSIS; FEMORAL-HEAD; RISK-FACTORS; CHILDREN; CHEMOTHERAPY; SURVIVORS; THERAPY Multiple languages Oncology; Hematology Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/15800