{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T23:43:19Z","timestamp":1788824599589,"version":"build-2803163510"},"reference-count":38,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,8,9]],"date-time":"2025-08-09T00:00:00Z","timestamp":1754697600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,8,9]],"date-time":"2025-08-09T00:00:00Z","timestamp":1754697600000},"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":["Br J Haematol"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:p>Although osteonecrosis (ON) is a common sequel after childhood acute lymphoblastic leukaemia treatment and may cause debilitating symptoms, its prognosis remains underexplored. We describe the radiological evolution of ON lesions in a Finnish patient cohort treated according to the The Nordic Society of Paediatric Haematology and Oncology (NOPHO) ALL2008 protocol. We aimed to identify the factors influencing the outcome of ON. We collected data from 37 patients diagnosed with ON treated in five tertiary centres. We analysed magnetic resonance imaging scans containing 235 ON lesions (109 affecting joints) and graded them using the Niinim\u00e4ki classification system. The mean follow\u2010up time from an ON diagnosis was 3.3\u2009years (SD 3.4 range: 0.04\u201313.5). Among the lesions with follow\u2010up scans, 55% remained stable, 35% resolved, 8% improved to lower grade and 2% progressed. Joint collapse was observed in 18 joint lesions (17%). Factors associated with unfavourable outcomes were female sex, older age at diagnosis and haematopoietic stem cell transplantation (HSCT). The chance for spontaneous resolution of ON was lower in females (adjusted odds ratio [aOR] 10.3, 95% CI 2.0\u201352.6) and decreased with age (aOR 1.4, 95% CI 1.1\u20131.7), whereas HSCT was associated with joint collapse already at ON diagnosis (aOR 8.3, 95% CI 2.6\u201327.0).<\/jats:p>","DOI":"10.1111\/bjh.70085","type":"journal-article","created":{"date-parts":[[2025,8,9]],"date-time":"2025-08-09T07:34:25Z","timestamp":1754724865000},"page":"1912-1919","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Follow\u2010up of osteonecrosis in paediatric acute lymphoblastic leukaemia patients treated with the\n                    <scp>NOPHO ALL<\/scp>\n                    2008 protocol"],"prefix":"10.1111","volume":"207","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9879-0527","authenticated-orcid":false,"given":"Roosa","family":"Rokkanen","sequence":"first","affiliation":[{"name":"Research Unit of Clinical Medicine 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Tampere University  Tampere Finland"},{"name":"Department of Children and Adolescents Tampere University Hospital  Tampere Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tytti","family":"Pokka","sequence":"additional","affiliation":[{"name":"Research Service Unit Oulu University Hospital  Oulu Finland"},{"name":"Research Unit of Clinical Medicine and Medical Research Centre Oulu University of Oulu  Oulu Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tuuli","family":"P\u00f6yh\u00f6nen","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Kuopio University Hospital  Kuopio Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Suo\u2010Palosaari","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Radiology Oulu University Hospital and Research Unit of Medical Imaging, Physics, and Technology Medical Research Center Oulu, University of Oulu  Oulu Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pauliina","family":"Utriainen","sequence":"additional","affiliation":[{"name":"Department of Paediatric Hematology, Oncology and Stem Cell Transplantation Children's Hospital, University of Helsinki and Helsinki University Hospital  Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liisa","family":"J\u00e4rvel\u00e4","sequence":"additional","affiliation":[{"name":"Department of Paediatrics and Adolescent Medicine Turku University Hospital and University of Turku  Turku Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riitta","family":"Niinim\u00e4ki","sequence":"additional","affiliation":[{"name":"Research Unit of Clinical Medicine University of Oulu  Oulu Finland"},{"name":"Department of Paediatrics and Adolescent Medicine Oulu University Hospital  Oulu 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