New Method Predicts Hip Joint Decay From Chemotherapy

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 paediatric leukaemia or lymphoma treatment.

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 most at risk for this complication. Eventually, genetic or other tests may be developed to help predict these patients. This is a subject of ongoing study.A report on this work appears in the Journal of Clinical Oncology.”Being able to predict which children are likely to experience serious bone deterioration in the future will help investigators identify and monitor those 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,” she said.(Source: Journal of Clinical Oncology : St. Jude Children’s Research Hospital : May 2007.)