Presentation and outcomes for children with bone marrow necrosis and acute lymphoblastic leukemia: a literature review.

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Bone marrow necrosis is a rare histopathology finding with the majority of cases occurring in the setting of a hematologic malignancy. This article reports a case of diffuse marrow necrosis in a child secondary to acute lymphoblastic leukemia and summarizes the clinical features and outcomes for children with bone marrow necrosis secondary to leukemia from 20 published reports. This review demonstrated that the most common presenting features were bone pain, fever, pancytopenia, and that outcomes were less favorable when compared with those without necrosis. However, contemporary literature suggests that outcomes are similar for children who have bone marrow necrosis secondary to leukemia when compared with overall survival rates for pediatric leukemia.





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Shah, Nirmish R, Daniel B Landi, Susan G Kreissman, Evan Kulbachi and Cassandra Moran (2011). Presentation and outcomes for children with bone marrow necrosis and acute lymphoblastic leukemia: a literature review. Journal of pediatric hematology/oncology, 33(7). pp. e316–e319. 10.1097/mph.0b013e318223fe9b Retrieved from

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Nirmish Ramesh Shah

Associate Professor of Medicine

Daniel Bryce Landi

Assistant Professor of Pediatrics

Susan Gail Kreissman

Professor of Pediatrics

The emphasis of Dr Kreissman's clinical research involves the study of childhood neuroblastoma. Neuroblastoma is the most common extracranial solid tumor of childhood and this disease has a diverse clinical phenotype and prognosis. Dr Kreissman has developed, written, and served as national protocol chairman for 2 clinical trials designed to improve outcome for children with the high risk form of this disease through the Children's Oncology Group (COG). Results of this protocol have been published " A Randomized Study of Purged Versus Unpurged Peripheral Blood Stem Cell Transplant Following Dose Intensive Induction Therapy for High Risk Neuroblastoma" and established the new standard of using unpurged PBSC to support autologous transplant in high risk neuroblastoma. Dr. Kreissman has served as a member of the Neuroblastoma committees for COG. She was involved in designing and implimenting additional new protocols for the treatment of neuroblastoma.

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