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The potential role of asparaginase in increasing risk of ON via effects on coagulation, lipid metabolism, and steroid clearance is now also recognised. Paediatric studies consistently identify age as a key risk factor for ON, with adolescents at higher risk than young children. Fewer studies comprehensively report on risk of ON in adults, but available evidence suggests that adolescents and young adults (AYAs) treated with corticosteroid and asparaginase\u2010containing paediatric\u2010inspired regimens are more at risk than older adults treated with paediatric\u2010inspired or traditional adult regimens. There are few proven strategies to prevent or mitigate the severity of ON and other orthopaedic complications of ALL therapy. Future clinical trials should carefully ascertain orthopaedic adverse events in adults. Evidence\u2010based guidelines should be developed for management of orthopaedic adverse events in adults being treated for ALL, especially high\u2010risk AYAs being treated with paediatric\u2010inspired regimens.<\/jats:p>","DOI":"10.1111\/bjh.18093","type":"journal-article","created":{"date-parts":[[2022,3,21]],"date-time":"2022-03-21T12:13:44Z","timestamp":1647864824000},"page":"421-430","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Orthopaedic adverse events among adolescents and adults treated with asparaginase for acute lymphoblastic leukaemia"],"prefix":"10.1111","volume":"198","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8927-8006","authenticated-orcid":false,"given":"Yannis K.","family":"Valtis","sequence":"first","affiliation":[{"name":"Department of Medicine Brigham and Women\u2019s Hospital  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew E.","family":"Place","sequence":"additional","affiliation":[{"name":"Department of Pediatric Oncology Dana\u2010Farber Cancer Institute and Division of Pediatric Hematology Oncology, Boston Children\u2019s Hospital  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lewis B.","family":"Silverman","sequence":"additional","affiliation":[{"name":"Department of Pediatric Oncology Dana\u2010Farber Cancer Institute and Division of Pediatric Hematology Oncology, Boston Children\u2019s Hospital  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lynda M.","family":"Vrooman","sequence":"additional","affiliation":[{"name":"Department of Pediatric Oncology Dana\u2010Farber Cancer Institute and Division of Pediatric Hematology Oncology, Boston Children\u2019s Hospital  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel J.","family":"DeAngelo","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Dana\u2010Farber Cancer Institute  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marlise R.","family":"Luskin","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Dana\u2010Farber Cancer Institute  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,3,21]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2016.147595"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2003.02.053"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.22189"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/bcj.2014.72"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2018-10-881961"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1038\/leu.2014.229"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2008.18.6916"},{"key":"e_1_2_11_9_1","unstructured":"National Comprehensive Cancer Network.Acute lymphoblastic Leukemia(1.2021).Available from:https:\/\/www.nccn.org\/professionals\/physician_gls\/pdf\/all.pdf. 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