Efficiency of Iloprost Treatment for Chemotherapy-associated Osteonecrosis After Childhood Cancer

Background: The risk of developing avascular osteonecrosis (AVN) after chemotherapy is age related and, at up to 17% of all treated patients, relatively high.

Patients And Methods: In a prospective study, 8 patients (4 male, 4 female, 14.3+/-4.9 years old) were treated for symptomatic chemotherapy-associated AVN with intravenous infusion of iloprost. Association Research Circulation Osseus (ARCO) stages I-IV in 37 bones (25 joints) were treated.

Results: Follow-up was 20.8+/-17 months (range: 6-53 months). No serious adverse reactions due to the infusion with iloprost were recorded. Pain levels were lower and functional outcome measured as Harris Hip and Knee Society Scores improved by the latest follow up.

Conclusion: Our current data confirm the findings of other investigators that healing of advanced stages of AVN is not possible, but that in early stages of AVN, pain relief and an improvement of joint function can be achieved by iloprost.