Musculoskeletal involvement in childhood leukemia: Characteristics and survival outcomes

Abstract

Background Childhood leukemia with musculoskeletal (MSK) involvement mimics various conditions, which consequently leads to diagnostic delays. The clinical implication of MSK involvement in this disease on survival outcomes is inconclusive. This study aimed to compare characteristics and survival outcomes between MSK and non-MSK involvement in childhood leukemia. Methods The medical records of children newly diagnosed with acute leukemia of an age under 15 years were retrospectively reviewed. Two-to-one nearest-neighbor propensity score-matching was performed to obtain matched groups with and without MSK involvement. The Kaplan–Meier method and log-rank test were then used to assess the effect of MSK involvement on survival outcomes. Results Of 1042 childhood leukemia cases, 81 (7.8%) children had MSK involvement at initial presentation. MSK involvement was more likely in children with acute lymphoblastic leukemia than acute myeloid leukemia (p < 0.05). Hematologic abnormalities were less frequent in the MSK involvement group (p < 0.05). The absence of peripheral blast cells was significantly higher in the MSK involvement group (17.3% vs 9.6%, p = 0.04). Normal complete blood counts with absence of peripheral blast cells were found 2.5% of the children with MSK involvement. By propensity score-matching for comparable risk groups of children with and without MSK involvement, the 5-year overall survival was not significantly different (48.2% vs 57.4%, respectively, p = 0.22), nor was event-free survival (43.3% vs 51.8%, respectively, p = 0.31). Conclusion Childhood leukemia with MSK involvement had the characteristics of minimal or absent hematologic abnormalities and peripheral blast counts.

Management of hyperleukocytosis in pediatric acute myeloid leukemia using immediate chemotherapy without leukapheresis: results from the NOPHO-DBH AML 2012 Protocol

“…The main argument against LA is that a beneficial effect on early clinical outcomes has not been shown in clinical trials (7,8,10,11) and that long term prognosis is not improved (26)(27)(28). Other arguments against the procedure include the requirement of a central venous catheter, the decrease in number of platelets with the procedure, the rapid rebound of blasts after LA, possible time delay before full dose chemotherapy, costs, and the fact that the procedure is not available everywhere (29,30).…”

Kas iskelet sistemi yakınmalarında neoplastik hastalıkların değerlendirilmesi

“…Bizim çalışmamızda ise en sık saptanan malign hastalık NHL olup, ikinci sıklıkta saptanan malign hastalık ALL'dir. Yapılan çalışmalarda ALL hastalarında KİS yakınmalarının sıklığı %7,1 ile %62,3 arasında bulundu (2,8,14). Bu nedenle KİS yakınmaları ile başvuran hastaların malign hastalığa sahip olabileceği akılda tutulmalı ve takip sürecinde dikkatli olunmalıdır.…”

“…Bu nedenle kemik ağrısı olan hastaların daha dikkatli bir şekilde değerlendirilmesi gerektiğini düşünmekteyiz. Çalışmamızda literatürle benzer şekilde en sık etkilenen eklemler sırasıyla diz, kalça ve ayak bileğiydi (14,16,17). Malign hastalıklarda kalça en sık etkilenen ikinci eklem olarak karşımıza çıkarken, ayak bileği benign hastalıklarda en sık etkilenen ikinci eklemdi.…”

Publisher Correction: Musculoskeletal involvement in childhood leukemia: Characteristics and survival outcomes

“…The original publication of this article [ 1 ] contained reference to Figs. 1 and 2 , but these figures were not included in the article due to an error in the publication process.…”