Team approach: Management of osteonecrosis in children with acute lymphoblastic leukemia.


Journal

Pediatric blood & cancer
ISSN: 1545-5017
Titre abrégé: Pediatr Blood Cancer
Pays: United States
ID NLM: 101186624

Informations de publication

Date de publication:
11 2020
Historique:
received: 17 06 2019
revised: 29 05 2020
accepted: 01 06 2020
pubmed: 30 8 2020
medline: 20 1 2021
entrez: 30 8 2020
Statut: ppublish

Résumé

With current treatments for acute lymphoblastic leukemia (ALL), the overall prognosis for survival is favorable. Increasing emphasis is placed on recognizing and managing the long-term consequences of ALL and its treatment, particularly involving osteonecrosis. Early osteonecrosis diagnosis and management may improve outcomes and is best accomplished through coordinated teams that may include hematologic oncologists, radiologists, orthopedic surgeons, physical therapists, and the patient and their family. Magnetic resonance imaging is the "gold standard" for diagnosis of early-stage and/or multifocal osteonecrosis. Treatments for osteonecrosis in ALL patients are risk stratified and may include observation, corticosteroid or chemotherapy adjustment, and pharmaceutical or surgical approaches.

Identifiants

pubmed: 32860663
doi: 10.1002/pbc.28509
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

e28509

Commentaires et corrections

Type : CommentIn

Informations de copyright

© 2020 Wiley Periodicals LLC.

Références

Linet MS, Ries LA, Smith MA, Tarone RE, Devesa SS. Cancer surveillance series: recent trends in childhood cancer incidence and mortality in the United States. J Natl Cancer Inst. 1999;91(12):1051-1058.
Siegel DA, Henley SJ, Li J, Pollack LA, Van Dyne EA, White A. Rates and trends of pediatric acute lymphoblastic leukemia - United States, 2001-2014. MMWR Morb Mortal Wkly Rep. 2017;66(36):950-954.
Hyakuna N, Shimomura Y, Watanabe A, et al. Assessment of corticosteroid-induced osteonecrosis in children undergoing chemotherapy for acute lymphoblastic leukemia: a report from the Japanese Childhood Cancer and Leukemia Study Group. J Pediatr Hematol Oncol. 2014;36(1):22-29.
Kawedia JD, Kaste SC, Pei D, et al. Pharmacokinetic, pharmacodynamic, and pharmacogenetic determinants of osteonecrosis in children with acute lymphoblastic leukemia. Blood. 2011;117(8):2340-2347. quiz 2556.
Karol SE, Mattano LA, Jr, Yang W, et al. Genetic risk factors for the development of osteonecrosis in children under age 10 treated for acute lymphoblastic leukemia. Blood. 2016;127(5):558-564.
Karol SE, Yang W, Van Driest SL, et al. Genetics of glucocorticoid-associated osteonecrosis in children with acute lymphoblastic leukemia. Blood. 2015;126(15):1770-1776.
Mattano LA, Jr, Sather HN, Trigg ME, Nachman JB. Osteonecrosis as a complication of treating acute lymphoblastic leukemia in children: a report from the Children's Cancer Group. J Clin Oncol. 2000;18(18):3262-3272.
Toft N, Birgens H, Abrahamsson J, et al. Toxicity profile and treatment delays in NOPHO ALL2008-comparing adults and children with Philadelphia chromosome-negative acute lymphoblastic leukemia. Eur J Haematol. 2016;96(2):160-169.
Bullough PG, DiCarlo EF. Subchondral avascular necrosis: a common cause of arthritis. Ann Rheum Dis. 1990;49(6):412-420.
Ficat RP, Arlet J. Ischemia and Necrosis of Bone. Baltimore: Williams & Wilkins; 1980.
Huang GS, Chan WP, Chang YC, Chang CY, Chen CY, Yu JS. MR imaging of bone marrow edema and joint effusion in patients with osteonecrosis of the femoral head: relationship to pain. AJR Am J Roentgenol. 2003;181(2):545-549.
Yoshimura I, Naito M, Kanazawa K, et al. Arthroscopic treatment for an osteochondral defect of the talus after necrosis associated with acute lymphoblastic leukaemia: a case report. Foot Ankle Surg. 2010;16(4):e88-90.
Hunger SP, Mullighan CG. Acute lymphoblastic leukemia in children. N Engl J Med. 2015;373(16):1541-1552.
Liu C, Kawedia JD, Cheng C, et al. Clinical utility and implications of asparaginase antibodies in acute lymphoblastic leukemia. Leukemia. 2012;26(11):2303-2309.
Larsen EC, Devidas M, Chen S, et al. Dexamethasone and high-dose methotrexate improve outcome for children and young adults with high-risk B-acute lymphoblastic leukemia: a report from Children's Oncology Group Study AALL0232. J Clin Oncol. 2016;34(20):2380-2388.
Mattano LA, Jr, Devidas M, Nachman JB, et al. Effect of alternate-week versus continuous dexamethasone scheduling on the risk of osteonecrosis in paediatric patients with acute lymphoblastic leukaemia: results from the CCG-1961 randomised cohort trial. Lancet Oncol. 2012;13(9):906-915.
Yang L, Boyd K, Kaste SC, Kamdem Kamdem L, Rahija RJ, Relling MV. A mouse model for glucocorticoid-induced osteonecrosis: effect of a steroid holiday. J Orthop Res. 2009;27(2):169-175.
Rhodes A, Gray J, Harvey N, et al. Osteonecrosis following treatment for childhood acute lymphoblastic leukaemia: the Southampton Children's Hospital experience. J Child Orthop. 2017;11(6):440-447.
Koo KH, Kim R, Kim YS, et al. Risk period for developing osteonecrosis of the femoral head in patients on steroid treatment. Clin Rheumatol. 2002;21(4):299-303.
Mont MA, Hungerford DS. Non-traumatic avascular necrosis of the femoral head. J Bone Joint Surg Am. 1995;77(3):459-474.
Mont MA, Jones LC, Hungerford DS. Nontraumatic osteonecrosis of the femoral head: ten years later. J Bone Joint Surg Am. 2006;88(5):1117-1132.
Jaramillo D. What is the optimal imaging of osteonecrosis, Perthes, and bone infarcts? Pediatr Radiol. 2009;39(Suppl 2):S216-219.
Kaste SC, Karimova EJ, Neel MD. Osteonecrosis in children after therapy for malignancy. AJR Am J Roentgenol. 2011;196(5):1011-1018.
Kaste SC, Shidler TJ, Tong X, et al. Bone mineral density and osteonecrosis in survivors of childhood allogeneic bone marrow transplantation. Bone Marrow Transplant. 2004;33(4):435-441.
Mont MA, Cherian JJ, Sierra RJ, Jones LC, Lieberman JR. Nontraumatic osteonecrosis of the femoral head: where do we stand today? A ten-year update. J Bone Joint Surg Am. 2015;97(19):1604-1627.
Darge K, Jaramillo D, Siegel MJ. Whole-body MRI in children: current status and future applications. Eur J Radiol. 2008;68(2):289-298.
Larson E, Jones LC, Goodman SB, Koo KH, Cui Q. Early-stage osteonecrosis of the femoral head: where are we and where are we going in year 2018? Int Orthop. 2018;42(7):1723-1728.
Borges AH, Hoy J, Florence E, et al. Antiretrovirals, fractures, and osteonecrosis in a large international HIV cohort. Clin Infect Dis. 2017;64(10):1413-1421.
Glesby MJ, Hoover DR, Vaamonde CM. Osteonecrosis in patients infected with human immunodeficiency virus: a case-control study. J Infect Dis. 2001;184(4):519-523.
Sansgiri RK, Neel MD, Soto-Fourier M, Kaste SC. Unique MRI findings as an early predictor of osteonecrosis in pediatric acute lymphoblastic leukemia. AJR Am J Roentgenol. 2012;198(5):W432-439.
Kim HK, Kaste S, Dempsey M, Wilkes D. A comparison of non-contrast and contrast-enhanced MRI in the initial stage of Legg-Calve-Perthes disease. Pediatr Radiol. 2013;43(9):1166-1173.
Kuhlen M, Kunstreich M, Krull K, Meisel R, Borkhardt A. Osteonecrosis in children and adolescents with acute lymphoblastic leukemia: a therapeutic challenge. Blood Adv. 2017;1(14):981-994.
Kaste SC, Pei D, Cheng C, et al. Utility of early screening magnetic resonance imaging for extensive hip osteonecrosis in pediatric patients treated with glucocorticoids. J Clin Oncol. 2015;33(6):610-615.
Moya-Angeler J, Gianakos AL, Villa JC, Ni A, Lane JM. Current concepts on osteonecrosis of the femoral head. World J Orthop. 2015;6(8):590-601.
Niinimaki T, Harila-Saari A, Niinimaki R. The diagnosis and classification of osteonecrosis in patients with childhood leukemia. Pediatr Blood Cancer. 2015;62(2):198-203.
Sultan AA, Mohamed N, Samuel LT, et al. Classification systems of hip osteonecrosis: an updated review. Int Orthop. 2019;43(5):1089-1095.
Karimova EJ, Rai SN, Deng X, et al. MRI of knee osteonecrosis in children with leukemia and lymphoma: part 1, observer agreement. AJR Am J Roentgenol. 2006;186(2):470-476.
Sultan AA, Cantrell WA, Chughtai M, et al. Radiographic classification systems for osteonecrosis of the knee: a review of literature. Surg Technol Int. 2017;31:374-378.
Nishii T, Sugano N, Ohzono K, Sakai T, Sato Y, Yoshikawa H. Significance of lesion size and location in the prediction of collapse of osteonecrosis of the femoral head: a new three-dimensional quantification using magnetic resonance imaging. J Orthop Res. 2002;20(1):130-136.
Nam KW, Kim YL, Yoo JJ, Koo KH, Yoon KS, Kim HJ. Fate of untreated asymptomatic osteonecrosis of the femoral head. J Bone Joint Surg Am. 2008;90(3):477-484.
te Winkel ML, Pieters R, Wind EJ, Bessems JH, van den Heuvel-Eibrink MM. Management and treatment of osteonecrosis in children and adolescents with acute lymphoblastic leukemia. Haematologica. 2014;99(3):430-436.
Vora A. Management of osteonecrosis in children and young adults with acute lymphoblastic leukaemia. Br J Haematol. 2011;155(5):549-560.
Evans WE, Relling MV, Rodman JH, Crom WR, Boyett JM, Pui CH. Conventional compared with individualized chemotherapy for childhood acute lymphoblastic leukemia. N Engl J Med. 1998;338(8):499-505.
Rao SS, El Abiad JM, Puvanesarajah V, Levin AS, Jones LC, Morris CD. Osteonecrosis in pediatric cancer survivors: epidemiology, risk factors, and treatment. Surg Oncol. 2019;28:214-221.
Leblicq C, Laverdiere C, Decarie JC, et al. Effectiveness of pamidronate as treatment of symptomatic osteonecrosis occurring in children treated for acute lymphoblastic leukemia. Pediatr Blood Cancer. 2013;60(5):741-747.
Padhye B, Dalla-Pozza L, Little D, Munns C. Incidence and outcome of osteonecrosis in children and adolescents after intensive therapy for acute lymphoblastic leukemia (ALL). Cancer Med. 2016;5(5):960-967.
Greggio NA, Pillon M, Varotto E, et al. Short-term bisphosphonate therapy could ameliorate osteonecrosis: a complication in childhood hematologic malignancies. Case Rep Med;2010:206132.
Wiernikowski JT, Barr RD, Webber C, Guo CY, Wright M, Atkinson SA. Alendronate for steroid-induced osteopenia in children with acute lymphoblastic leukaemia or non-Hodgkin's lymphoma: results of a pilot study. J Oncol Pharm Pract. 2005;11(2):51-56.
Padhye B, Dalla-Pozza L, Little DG, Munns CF. Use of zoledronic acid for treatment of chemotherapy related osteonecrosis in children and adolescents: a retrospective analysis. Pediatr Blood Cancer. 2013;60(9):1539-1545.
Agarwala S, Banavali SD, Vijayvargiya M. Bisphosphonate combination therapy in the management of postchemotherapy avascular necrosis of the femoral head in adolescents and young adults: a retrospective study from India. J Glob Oncol. 2018;4:1-11.
Kotecha RS, Powers N, Lee SJ, Murray KJ, Carter T, Cole C. Use of bisphosphonates for the treatment of osteonecrosis as a complication of therapy for childhood acute lymphoblastic leukaemia (ALL). Pediatr Blood Cancer. 2010;54(7):934-940.
Kim HK, Aruwajoye O, Stetler J, Stall A. Effects of non-weight-bearing on the immature femoral head following ischemic osteonecrosis: an experimental investigation in immature pigs. J Bone Joint Surg Am. 2012;94(24):2228-2237.
Mont MA, Carbone JJ, Fairbank AC. Core decompression versus nonoperative management for osteonecrosis of the hip. Clin Orthop Relat Res. 1996;324:169-178.
Inaba H, Pui CH. Glucocorticoid use in acute lymphoblastic leukaemia. Lancet Oncol. 2010;11(11):1096-1106.
Neel MD, Karimova EJ. Osteonecrosis of the femoral head in pediatric cancer patients. Semin Arthroplasty. 2007;18:203-210.
Neumayr LD, Aguilar C, Earles AN, et al. Physical therapy alone compared with core decompression and physical therapy for femoral head osteonecrosis in sickle cell disease. Results of a multicenter study at a mean of three years after treatment. J Bone Joint Surg Am. 2006;88(12):2573-2582.
Burns J, Crosbie J, Ouvrier R, Hunt A. Effective orthotic therapy for the painful cavus foot: a randomized controlled trial. J Am Podiatr Med Assoc. 2006;96(3):205-211.
Sueki DG, Cleland JA, Wainner RS. A regional interdependence model of musculoskeletal dysfunction: research, mechanisms, and clinical implications. J Man Manip Ther. 2013;21(2):90-102.
Kaste SC, DeFeo BM, Neel MD, Weiss KS, Fernandez-Pineda I, Ness KK. Osteonecrosis of the shoulders in pediatric patients treated for leukemia or lymphoma: single-institutional experience. J Pediatr Orthop. 2019;39(2):104-110.
Arlet J, Ficat P, Lartigue G, Tran MA. [Clinical research on intraosseous pressure in the upper femoral metaphysis and epiphysis in humans. Application to the diagnosis of ischemia and necrosis]. Rev Rhum Mal Osteoartic. 1972;39(11):717-723.
Hungerford DS. Pathogenetic considerations in ischemic necrosis of bone. Can J Surg. 1981;24(6):583-587.
Yu X, Zhang D, Chen X, Yang J, Shi L, Pang Q. Effectiveness of various hip preservation treatments for non-traumatic osteonecrosis of the femoral head: a network meta-analysis of randomized controlled trials. J Orthop Sci. 2018;23(2):356-364.
Harreld KL, Marulanda GA, Ulrich SD, Marker DR, Seyler TM, Mont MA. Small-diameter percutaneous decompression for osteonecrosis of the shoulder. Am J Orthop (Belle Mead NJ). 2009;38(7):348-354.
LaPorte DM, Mont MA, Mohan V, Pierre-Jacques H, Jones LC, Hungerford DS. Osteonecrosis of the humeral head treated by core decompression. Clin Orthop Relat Res. 1998;355:254-260.
Stulberg BN, Davis AW, Bauer TW, Levine M, Easley K. Osteonecrosis of the femoral head. A prospective randomized treatment protocol. Clin Orthop Relat Res. 1991;268:140-151.
Pierce TP, Jauregui JJ, Elmallah RK, Lavernia CJ, Mont MA, Nace J. A current review of core decompression in the treatment of osteonecrosis of the femoral head. Curr Rev Musculoskelet Med. 2015;8(3):228-232.
Kapadia BH, Banerjee S, Cherian JJ, Jauregui JJ, Mont MA. Principles of core decompression for osteonecrosis of the hip. In: Koo KH, Mont MA, Jones LC, eds. Osteonecrosis. New York: Springer; 2014:279-284.
Camp JF. Core decompression of the femoral head for osteonecrosis. J Bone Joint Surg Am. 1986;68:1313-1319.
Mont MA, Ragland PS, Etienne G. Core decompression of the femoral head for osteonecrosis using percutaneous multiple small-diameter drilling. Clin Orthop Relat Res. 2004;429:131-138.
Song WS, Yoo JJ, Kim YM, Kim HJ. Results of multiple drilling compared with those of conventional methods of core decompression. Clin Orthop Relat Res. 2007;454:139-146.
Marker DR, Seyler TM, Ulrich SD, Srivastava S, Mont MA. Do modern techniques improve core decompression outcomes for hip osteonecrosis? Clin Orthop Relat Res. 2008;466(5):1093-1103.
Lieberman JR, Varthi AG. Osteonecrosis of the knee - which joint preservation procedures work? J Arthroplasty. 2014;29(1):52-56.
Daltro GC, Fortuna V, de Souza ES, et al. Efficacy of autologous stem cell-based therapy for osteonecrosis of the femoral head in sickle cell disease: a five-year follow-up study. Stem Cell Res Ther. 2015;6:110.
Gangji V, De Maertelaer V, Hauzeur JP. Autologous bone marrow cell implantation in the treatment of non-traumatic osteonecrosis of the femoral head: five year follow-up of a prospective controlled study. Bone. 2011;49(5):1005-1009.
Hernigou P, Dubory A, Homma Y, et al. Cell therapy versus simultaneous contralateral decompression in symptomatic corticosteroid osteonecrosis: a thirty year follow-up prospective randomized study of one hundred and twenty five adult patients. Int Orthop. 2018;42(7):1639-1649.
Sen RK, Tripathy SK, Aggarwal S, Marwaha N, Sharma RR, Khandelwal N. Early results of core decompression and autologous bone marrow mononuclear cells instillation in femoral head osteonecrosis: a randomized control study. J Arthroplasty. 2012;27(5):679-686.
Hernigou P, Flouzat-Lachaniette CH, Delambre J, et al. Osteonecrosis repair with bone marrow cell therapies: state of the clinical art. Bone. 2015;70:102-109.
Hernigou P, Guerin G, Homma Y, et al. History of concentrated or expanded mesenchymal stem cells for hip osteonecrosis: is there a target number for osteonecrosis repair? Int Orthop. 2018;42(7):1739-1745.
Andriolo L, Merli G, Tobar C, Altamura SA, Kon E, Filardo G. Regenerative therapies increase survivorship of avascular necrosis of the femoral head: a systematic review and meta-analysis. Int Orthop. 2018;42(7):1689-1704.
Piuzzi NS, Chahla J, Schrock JB, et al. Evidence for the use of cell-based therapy for the treatment of osteonecrosis of the femoral head: a systematic review of the literature. J Arthroplasty. 2017;32(5):1698-1708.
Villa JC, Husain S, van der List JP, Gianakos A, Lane JM. Treatment of pre-collapse stages of osteonecrosis of the femoral head: a systematic review of randomized control trials. Hss J. 2016;12(3):261-271.
de Rojas T, Martinez-Alvarez S, Lerma-Lara S, Diaz MA, Madero L, Ramirez M. Outcome of childhood leukaemia survivors and necrosis of the femoral head treated with autologous mesenchymal stem cells. Clin Transl Oncol. 2018;20(5):584-590.
Hernigou P, Beaujean F. Abnormalities in the bone marrow of the iliac crest in patients who have osteonecrosis secondary to corticosteroid therapy or alcohol abuse. J Bone Joint Surg Am. 1997;79(7):1047-1053.
Jayakumar P, Ramachandran M, Youm T, Achan P. Arthroscopy of the hip for paediatric and adolescent disorders: current concepts. J Bone Joint Surg Br. 2012;94(3):290-296.
Akgun I, Kesmezacar H, Ogut T, Kebudi A, Kanberoglu K. Arthroscopic microfracture treatment for osteonecrosis of the knee. Arthroscopy. 2005;21(7):834-843.
Werner A, Jager M, Schmitz H, Krauspe R. Joint preserving surgery for osteonecrosis and osteochondral defects after chemotherapy in childhood. Klin Padiatr. 2003;215(6):332-337.
Frank RM, Lee S, Levy D, et al. Osteochondral allograft transplantation of the knee: analysis of failures at 5 years. Am J Sports Med. 2017;45(4):864-874.
Gortz S, De Young AJ, Bugbee WD. Fresh osteochondral allografting for steroid-associated osteonecrosis of the femoral condyles. Clin Orthop Relat Res. 2010;468(5):1269-1278.
Murphy RT, Pennock AT, Bugbee WD. Osteochondral allograft transplantation of the knee in the pediatric and adolescent population. Am J Sports Med. 2014;42(3):635-640.
Gross AE, Shasha N, Aubin P. Long-term followup of the use of fresh osteochondral allografts for posttraumatic knee defects. Clin Orthop Relat Res. 2005;435:79-87.
Bayne O, Langer F, Pritzker KP, Houpt J, Gross AE. Osteochondral allografts in the treatment of osteonecrosis of the knee. Orthop Clin North Am. 1985;16(4):727-740.
Familiari F, Cinque ME, Chahla J, et al. Clinical outcomes and failure rates of osteochondral allograft transplantation in the knee: a systematic review. Am J Sports Med. 2018;46(14):3541-3549.
Flynn JM, Springfield DS, Mankin HJ. Osteoarticular allografts to treat distal femoral osteonecrosis. Clin Orthop Relat Res. 1994;303:38-43.
Makarewich CA, Anderson MB, Gililland JM, Pelt CE, Peters CL. Ten-year survivorship of primary total hip arthroplasty in patients 30 years of age or younger. Bone Joint J. 2018;100-B(7):867-874.
Bessette BJ, Fassier F, Tanzer M, Brooks CE. Total hip arthroplasty in patients younger than 21 years: a minimum, 10-year follow-up. Can J Surg. 2003;46(4):257-262.
Niinimaki R, Hansen LM, Niinimaki T, et al. Incidence of severe osteonecrosis requiring total joint arthroplasty in children and young adults treated for leukemia or lymphoma: a nationwide, register-based study in Finland and Denmark. J Adolesc Young Adult Oncol. 2013;2(4):138-144.
Clohisy JC, Oryhon JM, Seyler TM, et al. Function and fixation of total hip arthroplasty in patients 25 years of age or younger. Clin Orthop Relat Res. 2010;468(12):3207-3213.
Ledford CK, Vap AR, Bolognesi MP, Wellman SS. Total hip arthroplasty in very young bone marrow transplant patients. J Surg Orthop Adv. 2015;24(2):99-104.
Manoso MW, Boland PJ, Healey JH, Tyler W, Morris CD. Acetabular development after bipolar hemiarthroplasty for osteosarcoma in children. J Bone Joint Surg Br. 2005;87(12):1658-1662.
Torchia ME, Klassen RA, Bianco AJ. Total hip arthroplasty with cement in patients less than twenty years old. Long-term results. J Bone Joint Surg Am. 1996;78(7):995-1003.
Jager M, Endres S, Wilke A. [Total hip replacement in childhood, adolescence and young patients: a review of the literature]. Z Orthop Ihre Grenzgeb. 2004;142(2):194-212.
Cool WP, Carter SR, Grimer RJ, Tillman RM, Walker PS. Growth after extendible endoprosthetic replacement of the distal femur. J Bone Joint Surg Br. 1997;79(6):938-942.
Newman JM, George J, North WT, et al. Hematologic malignancies are associated with adverse perioperative outcomes after total hip arthroplasty. J Arthroplasty. 2017;32(8):2436-2443.
Newman JM, Wagner TC, Naziri Q, et al. Hematologic malignancies are associated with adverse perioperative outcomes following total knee arthroplasty. J Knee Surg. 2018;31(4):291-301.
Chalmers BP, Ledford CK, Statz JM, Mabry TM, Hanssen AD, Abdel MP. What risks are associated with primary THA in recipients of hematopoietic stem cell transplantation? Clin Orthop Relat Res. 2017;475(2):475-480.

Auteurs

Lynne C Jones (LC)

Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland.

Sue C Kaste (SC)

Department of Diagnostic Imaging, St. Jude Children's Research Hospital, Memphis, Tennessee.
Leukemia/Lymphoma Division, Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee.

Seth E Karol (SE)

Leukemia/Lymphoma Division, Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee.

Brian DeFeo (B)

Rehabilitation Services, St. Jude Children's Research Hospital, Memphis, Tennessee.

Harry K W Kim (HKW)

Center for Excellence in Hip Disorders, Texas Scottish Rite Hospital for Children, UT Southwestern Medical Center, Dallas, Texas.

Michael D Neel (MD)

Division of Orthopaedics, St. Jude Children's Research Hospital, Memphis, TN.

Adam S Levin (AS)

Division of Orthopaedic Oncology, Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland.

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