Osteonecrosis detected by whole body magnetic resonance (WB-MRI) in patients with Hodgkin lymphoma treated by BEACOPP

Purpose: The purpose of our retrospective study was to assessthe incidence of osteonecrosis in patients who received differentchemotherapies.Methods and Materials: We evaluated the Whole Body MagneticResonance (WB-MRI) scans performed on 42 patients with HodgkinLymphoma treated by three chemotherapy regimens (6 ABVD, 2 ABVD + 4BEACOPP, 2 ABVD + 8 BEACOPP), excluding the patients with main riskfactors for osteonecrosis.Results: Six out of 7 patients (85.7%) who received 8 BEACOPP and 1 outof 5 patients (20%) treated by 4 BEACOPP presented osteonecrosis, witha statistically significant difference of frequency between the two groups ofpatients (p<0.05); no injury has been reported in patients treated by onlyABVD. Among a total of 48 osteonecrotic lesions observed, the 47.9% weredetected in the knee; multifocal osteonecrosis were detected in 6 out of 7patients (85.7%).Conclusion: The development of osteonecrosis seems to be strictlyrelated to the chemotherapy protocol adopted and the number of cyclesreceived, strengthening the hypothesis of a correlation between the doseof corticosteroids included in the BEACOPP scheme and this complication.WB-MRI can be considered as a helpful tool that allows to early detectosteonecrotic lesions in patients treated with corticosteroids.