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. 2022 May 2;20(1):34.
doi: 10.1186/s12969-022-00692-9.

Musculoskeletal involvement in childhood leukemia: Characteristics and survival outcomes

Sirinthip Kittivisuit  1 , Pornpun Sripornsawan  1 , Natsaruth Songthawee  1 , Shevachut Chavananon  1 , Edward B McNeil  2 , Thirachit Chotsampancharoen  3
Affiliations

Musculoskeletal involvement in childhood leukemia: Characteristics and survival outcomes

Sirinthip Kittivisuit et al. Pediatr Rheumatol Online J. .

Erratum in

Abstract

BACKGROUND : Childhood leukemia with musculoskeletal (MSK) involvement mimics various conditions, which consequently leads to diagnostic delays. The clinical implication of MSK involvement in this disease on survival outcomes is inconclusive. This study aimed to compare characteristics and survival outcomes between MSK and non-MSK involvement in childhood leukemia.

Methods: The medical records of children newly diagnosed with acute leukemia of an age under 15 years were retrospectively reviewed. Two-to-one nearest-neighbor propensity score-matching was performed to obtain matched groups with and without MSK involvement. The Kaplan-Meier method and log-rank test were then used to assess the effect of MSK involvement on survival outcomes.

Results: Of 1042 childhood leukemia cases, 81 (7.8%) children had MSK involvement at initial presentation. MSK involvement was more likely in children with acute lymphoblastic leukemia than acute myeloid leukemia (p < 0.05). Hematologic abnormalities were less frequent in the MSK involvement group (p < 0.05). The absence of peripheral blast cells was significantly higher in the MSK involvement group (17.3% vs 9.6%, p = 0.04). Normal complete blood counts with absence of peripheral blast cells were found 2.5% of the children with MSK involvement. By propensity score-matching for comparable risk groups of children with and without MSK involvement, the 5-year overall survival was not significantly different (48.2% vs 57.4%, respectively, p = 0.22), nor was event-free survival (43.3% vs 51.8%, respectively, p = 0.31).

Conclusion: Childhood leukemia with MSK involvement had the characteristics of minimal or absent hematologic abnormalities and peripheral blast counts.

Keywords: Acute leukemia; Musculoskeletal involvement; Survival outcome.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Comparison of overall survival by musculoskeletal involvement among the 243 propensity-score matched study patients
Fig. 2
Fig. 2
Comparison of event free survival by musculoskeletal involvement among the 243 propensity-score matched patients
See this image and copyright information in PMC

References

    1. Bidwell SS, Peterson CC, Demanelis K, Zarins KR, Meza R, Sriplung H, et al. Childhood cancer incidence and survival in Thailand: A comprehensive population-based registry analysis, 1990–2011. Pediatr Blood Cancer. 2019;66:e27428. doi: 10.1002/pbc.27428. - DOI - PMC - PubMed
    1. Steliarova-Foucher E, Colombet M, Ries LA, Moreno F, Dolya A, Bray F, et al. International incidence of childhood cancer, 2001–10: a population-based registry study. Lancet Oncol. 2017;18:719–731. doi: 10.1016/S1470-2045(17)30186-9. - DOI - PMC - PubMed
    1. Clarke RT, Van den Bruel A, Bankhead C, Mitchell CD, Phillips B, Thompson MJ. Clinical presentation of childhood leukaemia: a systematic review and meta-analysis. Arch Dis Child. 2016;101:894–901. doi: 10.1136/archdischild-2016-311251. - DOI - PubMed
    1. Kai T, Ishii E, Matsuzaki A, Okamura J, Ikuno Y, Tasaka E, et al. Clinical and prognostic implications of bone lesions in childhood leukemia at diagnosis. Leuk Lymphoma. 1996;23:119–123. doi: 10.3109/10428199609054810. - DOI - PubMed
    1. Barbosa CM, Nakamura C, Terreri MT, Lee ML, Petrilli AS, Hilário MO. Musculoskeletal manifestations as the onset of acute leukemias in childhood. J Pediatr. 2002;78(6):481–4. doi: 10.2223/JPED.903. - DOI - PubMed