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 assess the incidence of osteonecrosis in patients who received different chemotherapies. Methods and Materials: We evaluated the Whole Body Magnetic Resonance (WB-MRI) scans performed on 42 patients with Hodgkin Lymphoma treated by three chemotherapy regimens (6 ABVD, 2 ABVD + 4 BEACOPP, 2 ABVD + 8 BEACOPP), excluding the patients with main risk factors for osteonecrosis. Results: Six out of 7 patients (85.7%) who received 8 BEACOPP and 1 out of 5 patients (20%) treated by 4 BEACOPP presented osteonecrosis, with a statistically significant difference of frequency between the two groups of patients (p<0.05); no injury has been reported in patients treated by only ABVD. Among a total of 48 osteonecrotic lesions observed, the 47.9% were detected in the knee; multifocal osteonecrosis were detected in 6 out of 7 patients (85.7%). Conclusion: The development of osteonecrosis seems to be strictly related to the chemotherapy protocol adopted and the number of cycles received, strengthening the hypothesis of a correlation between the dose of corticosteroids included in the BEACOPP scheme and this complication. WB-MRI can be considered as a helpful tool that allows to early detect osteonecrotic lesions in patients treated with corticosteroids.