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Case Reports in Medicine
Volume 2010 (2010), Article ID 206132, 5 pages
http://dx.doi.org/10.1155/2010/206132
Case Report

Short-Term Bisphosphonate Therapy Could Ameliorate Osteonecrosis: A Complication in Childhood Hematologic Malignancies

1Pediatric Endocrinology and Adolescence, Department of Pediatrics, Hospital-University of Padova, 35128 Padova, Italy
2Hemo/Oncology, Department of Pediatrics, Hospital-University of Padova, 35128 Padova, Italy
3Pediatric Radiology, Department of Pediatrics, Hospital-University of Padova, 35128 Padova, Italy
4Pharmacy, Veneto Oncology Institute - IRCCS, 35128 Padova, Italy

Received 6 March 2010; Accepted 25 April 2010

Academic Editor: Werner Rabitsch

Copyright © 2010 N. A. Greggio et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Osteonecrosis (ON) is a critical complication in the treatment of childhood leukemia and lymphoma. It particularly affects survivors of acute lymphoblastic leukemia and non-Hodgkin lymphoma reflecting the cumulative exposure to glucocorticosteroid therapy. ON is often multiarticular and bilateral, specially affecting weight-bearing joints. A conventional approach suggests a surgical intervention even if pharmacological options have also recently been investigated. We reported two cases of long time steroid-treated patients who underwent Bone Marrow Transplantation (BMT) for hematological disease. Both patients developed femoral head osteonecrosis (ON) that was diagnosed by magnetic resonance imaging (MRI) and the ON was also accompanied with pain and a limp. Despite of the conventional strategies of therapy, we successfully started a short-term treatment with bisphosphonates in order to decrease the pain and the risk of fracture.