Team approach: Management of osteonecrosis in children with acute lymphoblastic leukemia
Lynne C Jones1, Sue C Kaste2,3, Seth E Karol3
1Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland.
Insights
Acute lymphoblastic leukemia (ALL) survivors face long-term risks like osteonecrosis. Early diagnosis via MRI and multidisciplinary team management are crucial for better outcomes.
Area of Science:
- Oncology
- Orthopedics
- Radiology
Background:
- Current acute lymphoblastic leukemia (ALL) treatments offer a favorable survival prognosis.
- Long-term consequences of ALL and its treatment, especially osteonecrosis, require increasing attention.
- Effective management of osteonecrosis is vital for improving the quality of life for ALL survivors.
Purpose of the Study:
- To highlight the importance of recognizing and managing osteonecrosis in acute lymphoblastic leukemia (ALL) patients.
- To emphasize the role of multidisciplinary teams in the early diagnosis and management of osteonecrosis.
- To outline current diagnostic standards and treatment strategies for osteonecrosis in ALL.
Main Methods:
- Review of current literature on osteonecrosis in ALL patients.
- Emphasis on the diagnostic capabilities of Magnetic Resonance Imaging (MRI) for early and multifocal osteonecrosis.
- Description of risk-stratified treatment approaches.
Main Results:
- Osteonecrosis is a significant long-term complication of ALL treatment.
- Magnetic Resonance Imaging (MRI) is the gold standard for diagnosing early-stage and multifocal osteonecrosis.
- Multidisciplinary team approach is essential for optimal patient care.
Conclusions:
- Early diagnosis and management of osteonecrosis in ALL patients can improve outcomes.
- Coordinated care involving hematologic oncologists, radiologists, orthopedic surgeons, and physical therapists is recommended.
- Treatment strategies are individualized based on risk stratification and may include observation, medication adjustment, or surgical intervention.
Abstract:
With current treatments for acute lymphoblastic leukemia (ALL), the overall prognosis for survival is favorable. Increasing emphasis is placed on recognizing and managing the long-term consequences of ALL and its treatment, particularly involving osteonecrosis. Early osteonecrosis diagnosis and management may improve outcomes and is best accomplished through coordinated teams that may include hematologic oncologists, radiologists, orthopedic surgeons, physical therapists, and the patient and their family. Magnetic resonance imaging is the "gold standard" for diagnosis of early-stage and/or multifocal osteonecrosis. Treatments for osteonecrosis in ALL patients are risk stratified and may include observation, corticosteroid or chemotherapy adjustment, and pharmaceutical or surgical approaches.
Related Concept Videos
01:22Acute Kidney Injury VI: Nursing Management
01:22Bone Marrow Sampling and Transplants
The transplant begins with high doses of chemotherapy and radiation treatment, which aim to destroy...
01:20Acute Kidney Injury V: Interprofessional Care
01:27Fractures: Bone Repair
Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the...
01:16Kidney Transplant III: Nursing Management
01:18Chronic Kidney Disease IV: Nursing Management