Avascular necrosis of hematopoietic stem cell transplantation (HSCT): state of the art

Avascular necrosis (AVN) is a complex, multifactorial disease that may affect one bone, several bones together, or different bones at different times and it can impair the patient’s quality of life. It predominantly occurs in the femoral head, but also commonly affects other sites, especially the femur and knees, causing severe pain, bone necrosis, and, in extreme cases, even bone collapse. It can be diagnosed by magnetic resonance imaging analysis, and is usually staged using the Association of Research Circulation Osseus (ARCO) system or the Ficat system. Currently, literature on the prevention and treatment of AVN is very scanty, and studies are based on retrospective analyses. The aim of this review is to analyze the state of the art with regard to risk factors and treatments for AVN in patients who have received a hematopoietic stem cell transplant. KEY WORDS: Avascular necrosis, AVN, osteonecrosis, HSCT.