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High incidence of aseptic hip necrosis in Hodgkin lymphoma patients treated with escalated BEACOPP receiving methylprednisolone
Author(s) -
BasicKinda Sandra,
Karlak Ivan,
Durakovic Nadira,
Lubina Zvonimir I.,
Livaja Radman Ivo,
Dotlic Snježana,
Peric Zinaida,
Hude Ida,
Aurer Igor
Publication year - 2018
Publication title -
internal medicine journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.596
H-Index - 70
eISSN - 1445-5994
pISSN - 1444-0903
DOI - 10.1111/imj.13653
Subject(s) - medicine , avascular necrosis , prednisone , methylprednisolone , cumulative incidence , surgery , incidence (geometry) , femoral head , lymphoma , regimen , risk factor , magnetic resonance imaging , radiology , transplantation , physics , optics
Background Escalated BEACOPP (eBEACOPP) is an effective but fairly toxic regimen for the treatment of Hodgkin lymphoma (HL). Avascular necrosis (AVN) of femoral head was previously reported to increase in patients treated with eBEACOPP, but so far, no systematic analysis of its frequency has been published. Aims To analyse the frequency and identify possible risk factors for AVN development in patients treated with eBEACOPP. Methods We identified 26 patients treated with eBEACOPP for newly diagnosed high‐risk advanced‐stage HL, 25 of whom were alive at the time of study. All patients were invited to participate in a cross‐sectional study; 17 patients responded and were evaluated by magnetic resonance imaging and orthopaedic examination. Results Six patients (35.3%) were diagnosed with AVN after receiving eBEACOPP treatment. AVN was not correlated with age, gender, number of received eBEACOPP cycles, irradiation therapy or cumulative dose of steroids administered. There were significantly more cases of AVN in patients receiving methylprednisolone than prednisone ( P = 0.01). Conclusion The use of methylprednisolone was shown to be a risk factor for the development of AVN in patients treated with eBEACOPP and should not be the corticosteroid of choice in the treatment of patients with HL.