Campbell et al identified risk factors for avascular necrosis of bone following a hematopoietic cell transplant. Avascular necrosis (AVN) is a painful and potentially disabling condition. The authors are from City of Hope National Medical Center in Duarte, California, and Albert Einstein College of Medicine in da Bronx.
Rates of AVN after 10 years:
(1) 3% after autologous transplant
(2) 5% after allogeneic matched donor transplant
(3) 15% after allogeneic unrelated donor transplant
Risk factors for avascular necrosis from multivariate analysis following autologous transplant:
(1) none identified
Risk factors for avascular necrosis from multivariate analysis following allogeneic transplant:
(1) male gender
(2) chronic graft-vs-host disease (GVHD)
(3) cyclosporine with or without prednisone
(4) addition of FK506 (tacrolimus) and mycophenolate mofetil (MMF)
where:
• The number of combinations for the drugs were limited (only 6 of 16 combinations listed).
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