Featured Research

from universities, journals, and other organizations

New Method Predicts Hip Joint Decay From Chemotherapy

Date:
April 23, 2007
Source:
St. Jude Children's Research Hospital
Summary:
Investigators say they have found the best way for predicting when patients will need future surgery to repair hip joints that have deteriorated because of pediatric leukemia or lymphoma treatment.

Investigators at St. Jude Children's Research Hospital say they have found the best way for predicting when patients will need future surgery to repair hip joints that have deteriorated because of pediatric leukemia or lymphoma treatment.

Related Articles


The investigators found that if more than 30 percent of the head of the bone fitting into the hip socket is deteriorated, it is at high risk of collapsing and requiring reconstructive surgery within two years.

The study is significant because the intensive use of corticosteroid drugs that have been implicated in development of osteonecrosis, or bone deterioration, is a major component of chemotherapy for pediatric leukemia and lymphoma. The drugs have been key to raising the survival rates of children with these cancers, and currently there is no adequate substitute for their use. Therefore, it is important for clinicians to monitor patients during treatment and identify those at highest risk for this complication. Eventually, genetic or other tests may be developed to help predict these patients. This is a subject of ongoing study.

Hip collapse occurs following deterioration of the ball-like top part of the upper leg bone, or femur, which fits into the hip socket. Degeneration of this area, called osteonecrosis of the capital femoral epiphysis, is a common problem among children undergoing chemotherapy for leukemia or lymphoma.

"Being able to predict which children are likely to experience serious bone deterioration in the future will help investigators identify and monitor survivors who are at particularly high risk for developing this problem," said Sue Kaste, D.O., a member of the Radiological Sciences department at St. Jude. Kaste is the paper's senior author.

Collapse of the femur causes severe pain that might leave the patient wheelchair bound, according to Evguenia Jane Karimova, M.D., Radiological Sciences department at St. Jude and the paper's first author. To ease the pain, many patients require arthroplasty, or surgery to rebuild the hip joint.

"Hip collapse and joint replacement carry a worse prognosis in a young person," Karimova said. "Young patients tend to engage in more strenuous activity than older patients with hip replacements, and that can damage the replacement and further complicate recovery. Many of these patients are expected to require further surgery in the future to replace their prostheses, which have a limited life span."

"Osteonecrosis has become one of the most important side effects of therapy that affects the quality of life of these long-term survivors," Kaste said. "We want the survivors to have the best quality of life possible. Therefore, we analyzed the extensive amount of data on such patients accumulated at St. Jude over the years to determine which factors cause joint collapse and make it likely that the patient will need arthroplasty."

The St. Jude team reviewed the medical records and MRI images of 80 patients who developed osteonecrosis of the capital femoral epiphysis to identify factors that appeared to be linked to the future collapse of the bone's surface and the need for arthroplasty. A total of 23 of the 80 patients, or 29 percent, eventually underwent arthroplasty for one or both hips at an average of 1.3 years after diagnosis of osteonecrosis. In cases in which necrosis involved more than 30 percent of the head of the hip, 80 percent of the hips collapsed within two years after osteonecrosis was identified, with 50 percent requiring arthroplasty. The age of the patient at the time of the first arthroplasty ranged from 15.1 to 35.4 years.

The investigators plan to conduct prospective studies to determine if it is possible to develop a treatment that prevents this damage and preserves hip function.

A report on this work appears in the April 20 issue of "Journal of Clinical Oncology."

Other authors of this study are Shesh N. Rai, Scott C. Howard, Michael Neel, Lunetha Britton and Ching-Hon Pui.

This work was supported by the National Institutes of Health, the American Cancer Society and ALSAC.


Story Source:

The above story is based on materials provided by St. Jude Children's Research Hospital. Note: Materials may be edited for content and length.


Cite This Page:

St. Jude Children's Research Hospital. "New Method Predicts Hip Joint Decay From Chemotherapy." ScienceDaily. ScienceDaily, 23 April 2007. <www.sciencedaily.com/releases/2007/04/070419140907.htm>.
St. Jude Children's Research Hospital. (2007, April 23). New Method Predicts Hip Joint Decay From Chemotherapy. ScienceDaily. Retrieved October 26, 2014 from www.sciencedaily.com/releases/2007/04/070419140907.htm
St. Jude Children's Research Hospital. "New Method Predicts Hip Joint Decay From Chemotherapy." ScienceDaily. www.sciencedaily.com/releases/2007/04/070419140907.htm (accessed October 26, 2014).

Share This



More Health & Medicine News

Sunday, October 26, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Texas Nurse Nina Pham Cured of Ebola

Texas Nurse Nina Pham Cured of Ebola

AFP (Oct. 25, 2014) — An American nurse who contracted Ebola while caring for a Liberian patient in Texas has been declared free of the virus and will leave the hospital. Duration: 01:01 Video provided by AFP
Powered by NewsLook.com
Toxin-Packed Stem Cells Used To Kill Cancer

Toxin-Packed Stem Cells Used To Kill Cancer

Newsy (Oct. 25, 2014) — A Harvard University Research Team created genetically engineered stem cells that are able to kill cancer cells, while leaving other cells unharmed. Video provided by Newsy
Powered by NewsLook.com
IKEA Desk Converts From Standing to Sitting With One Button

IKEA Desk Converts From Standing to Sitting With One Button

Buzz60 (Oct. 24, 2014) — IKEA is out with a new convertible desk that can convert from a sitting desk to a standing one with just the push of a button. Jen Markham explains. Video provided by Buzz60
Powered by NewsLook.com
Ebola Protective Suits Being Made in China

Ebola Protective Suits Being Made in China

AFP (Oct. 24, 2014) — A factory in China is busy making Ebola protective suits for healthcare workers and others fighting the spread of the virus. Duration: 00:38 Video provided by AFP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
 
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:  

Breaking News:

Strange & Offbeat Stories

 

Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:  

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile iPhone Android Web
Follow Facebook Twitter Google+
Subscribe RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins