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Total body irradiation-induced osteochondromata

G D Harper1, C Dicks-Mireaux, A D Leiper

  • 1Department of Radiology and Haematology/Oncology, Great Ormond Street Hospital for Children NHS Trust, London, United Kingdom.

Journal of Pediatric Orthopedics
|May 26, 1998
PubMed
Summary

Total body irradiation (TBI) before bone marrow transplantation for childhood leukemia can lead to radiation-induced osteochondromata (RIO). These benign bone tumors, often multiple, appeared years after TBI and showed no signs of malignancy.

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Area of Science:

  • Oncology
  • Pediatric Hematology/Oncology
  • Radiation Oncology

Background:

  • Childhood leukemia survivors treated with total body irradiation (TBI) before bone marrow transplantation (BMT) are at risk for long-term complications.
  • Osteochondromata are benign bone tumors, but their development after TBI requires careful monitoring.

Purpose of the Study:

  • To investigate the incidence and characteristics of osteochondromata developing after TBI in pediatric leukemia patients.
  • To assess the clinical course and malignant potential of radiation-induced osteochondromata (RIO).

Main Methods:

  • Retrospective analysis of nine patients who developed osteochondromata after TBI and BMT for childhood leukemia.
  • Long-term follow-up to assess tumor characteristics, growth, and any signs of malignant transformation.

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Main Results:

  • Nine patients (23% of eligible survivors) developed osteochondromata a mean of 6 years post-TBI.
  • No osteochondromata showed evidence of malignant change; surgical removal was performed on three lesions.
  • Growth hormone therapy for irradiation-induced deficiency did not influence osteochondromata development or progression.

Conclusions:

  • Total body irradiation for childhood leukemia is associated with a significant incidence of radiation-induced osteochondromata (RIO).
  • RIO are typically benign and do not appear to undergo malignant transformation.
  • The incidence of RIO following TBI may be higher than previously reported after local irradiation.