{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,26]],"date-time":"2026-04-26T17:36:53Z","timestamp":1777225013608,"version":"3.51.4"},"reference-count":31,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T00:00:00Z","timestamp":1774224000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T00:00:00Z","timestamp":1774224000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["eJHaem"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Osteonecrosis is a clinically relevant therapy\u2010associated complication in pediatric acute lymphoblastic leukemia (ALL).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In a nationwide Austrian cohort of 1127 patients with newly diagnosed ALL treated on AIEOP\u2010BFM\u2010ALL 2000 and 2009 protocols, 73 patients developed symptomatic osteonecrosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The corresponding 5\u2010year cumulative incidence was 7%\u00a0\u00b1\u00a01%, while competing events such as relapse, death, and secondary malignancies were at 13%\u00a0\u00b1\u00a01%. Median time to osteonecrosis was 1.64 years. Age at diagnosis was the dominant risk factor: the 5\u2010year incidence was 22%\u00a0\u00b1\u00a03% in adolescent patients 10\u201318 versus 2%\u00a0\u00b1\u00a00% in those 1\u20139 years\u2010old.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Age remained the only statistically independent predictor for osteonecrosis in multivariable analysis.<\/jats:p>\n                    <jats:p>\n                      <jats:bold>Trial Registration<\/jats:bold>\n                      : The authors have confirmed clinical trial registration is not needed for this submission\n                    <\/jats:p>\n                  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