骨坏死（ON）是癌症治疗的一种潜在的致残性骨骼并发症。尽管症状性骨坏死 (sON) 在急性淋巴细胞白血病 (ALL) 中众所周知，发病率约为 6%，但关于小儿霍奇金淋巴瘤 (HL) 中 sON 的研究却很少。本研究的目的是检查接受 HL 治疗的儿童中 sON 的发病率、危险因素和结果。2005 年至 2019 年间，瑞典、芬兰和丹麦共有 490 名 18 岁以下儿童被诊断为 HL，有资格接受该研究。学习。从患者的病历中收集有关患者特征、HL 治疗和 sON 发展的数据。使用磁共振成像扫描来建立 ON 诊断并根据 Niinimäki 分级系统对 ON 进行分级。489 名患者中 sON 的 2 年累积发病率为 5.5%（n = 30）。年龄较大的人（优势比 [OR] 1.25，95% 置信区间 [CI]：1.05-1.49，p < .010）、女性（OR 4.45，CI 1.87-10.58，p < 0.001）、高总累积糖皮质激素 (GC) 剂量（OR 1.76，95% CI：1.21-2.56，p = 0.003）和晚期 HL（OR 2.19，95% CI：1.03-4.65，p = 0.042） 。 4 名 (13.3%) 患者接受了大型外科手术，其中 13 名 (43.3%) 患者在随访时因 ON 出现持续症状。这项研究表明，sON 在儿童 HL 中与儿童 ALL 中一样常见，其危险因素包括年龄较大、女性、高累积 GC 剂量和晚期 HL。未来的 HL 方案开发应旨在通过修改 GC 治疗来减轻 ON 的负担。© 2024 作者。儿科血液

Osteonecrosis (ON) is a potentially disabling skeletal complication of cancer treatment. Although symptomatic osteonecrosis (sON) is well-known in acute lymphoblastic leukemia (ALL), with an incidence around 6%, studies on sON in pediatric Hodgkin lymphoma (HL) are scarce. The aim of this study was to examine the incidence, risk factors, and outcome of sON in children treated for HL.A total of 490 children under 18, diagnosed with HL between 2005 and 2019 in Sweden, Finland, and Denmark were eligible for the study. Data on patient characteristics, HL treatment, and development of sON were collected from patients' medical records. Magnetic resonance imaging scans were used to establish ON diagnosis and grade ON according to the Niinimäki grading system.Cumulative 2-year incidence of sON among the 489 included patients was 5.5% (n = 30). The risk for developing sON was higher for those with older age (odds ratio [OR] 1.25, 95% confidence interval [CI]: 1.05-1.49, p < .010), female sex (OR 4.45, CI 1.87-10.58, p < .001), high total cumulative glucocorticoid (GC) doses (OR 1.76, 95% CI: 1.21-2.56, p = 0.003), and advanced HL (OR 2.19, 95% CI: 1.03-4.65, p = .042). Four (13.3%) patients underwent major surgical procedures and 13 (43.3%) had persistent symptoms due to ON at follow-up.This study shows that sON is as common in pediatric HL as in pediatric ALL, with risk factors such as older age, female sex, high cumulative GC doses, and advanced HL. Future HL protocol development should aim to reduce the burden of ON by modifying GC treatment.© 2024 The Author(s). Pediatric Blood & Cancer published by Wiley Periodicals LLC.