Symptomatic osteonecrosis in recipients of nonautologous bone marrow transplants

A retrospective study of 36 allogeneic bone marrow transplant recipients was conducted to determine the rate of occurrence of and risk factors for avascular osteonecrosis. Eight patients developed osteonecrosis, after a mean time interval of 18 months. Multiple sites were often involved (mean 2.37 per patient). Advanced roentgenologic lesions were present at diagnosis in most instances. The occurrence of osteonecrosis was not significantly correlated with the initial hematologic diagnosis, the preparative regimen, serum lipid abnormalities, presence of acute or chronic graft-versus-host disease, or corticosteroid therapy characteristics. Intraosseous blood vessels exhibited histologic lesions consistent with a role of graft-versus-host-disease vasculitis in the occurrence of osteonecrosis in nonautologous bone marrow transplant recipients.