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Post-Transplant Complications

Femoral head necrosis in three patients with relapsed ovarian cancer receiving high-dose chemotherapy followed by autologous peripheral blood stem cell transplantation

Bone Marrow Transplantation volume 31, pages 487–491 (2003)Cite this article

Summary:

We report three patients with relapsed ovarian cancer who developed femoral head necrosis requiring endoprosthetic hip surgery 16–35 months after high-dose chemotherapy (HDC) with treosulfan (47 and 56 g/m2 body-surface area (BSA)) given as 3–25 h infusions and followed by autologous peripheral blood stem cell (PBSC) transplantation. One woman received two courses of single agent treosulfan while the other two patients received one course of high-dose treosulfan either preceded or followed by high-dose carboplatin, etoposide and cyclophosphamide. A total of 30 women with ovarian cancer were treated with HDC at our unit and 21 of them received treosulfan-containing regimens. Femoral head necrosis was not observed in patients either receiving conditioning regimens without treosulfan (n=9) or when the total treosulfan dose was given over 3 consecutive days (n=3) or in patients with a diagnosis other than ovarian cancer and treated with high-dose treosulfan (n=10). We conclude that women with relapsed ovarian cancer receiving HDC with excessive single-dose treosulfan might be at an increased risk of developing bone necrosis.

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Acknowledgements

We thank Dr C Poettgen, University of Essen Medical School, West German Cancer Center, Department of Radiotherapy for critical review of the radiation chart of patient 2, V.B.

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Authors and Affiliations

  1. Department of Internal Medicine (Cancer Research), West German Cancer Center, University of Essen Medical School, Essen, Germany

    P Bojko, R A Hilger, S Seeber & M E Scheulen

  2. Department of Radiology, University of Essen Medical School, Essen, Germany

    S G Ruehm

  3. Department of Pathology, University of Essen Medical School, Essen, Germany

    O Dirsch

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  1. P Bojko
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  2. R A Hilger
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  3. S G Ruehm
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  4. O Dirsch
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  5. S Seeber
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  6. M E Scheulen
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Bojko, P., Hilger, R., Ruehm, S. et al. Femoral head necrosis in three patients with relapsed ovarian cancer receiving high-dose chemotherapy followed by autologous peripheral blood stem cell transplantation. Bone Marrow Transplant 31, 487–491 (2003). https://doi.org/10.1038/sj.bmt.1703886

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