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Rickets


#1

Thank you all for your ongoing support. My son, Ian, is roughly 2 years post therapy and is clear on scans and doing well.

He has been complaining recently about pain in his legs. After some cursory examinations from his GP/Family Doctor, we decided to make sure it wasn't a larger issue by requesting some follow-up from his oncologist.

He was examined and nothing was evident from checking him physically, so they did xrays of his legs.

Upon reviewing his xrays, they believe he has rickets, most likely brought on by the chemo he received. It is apparently rare, but I was able to find a number of articles from NIH that reference this (it appears that ifosfamide has been linked to onset of a condition called Fanconi syndrome that causes issues with the kidneys processing certain nutrients):

http://www.ncbi.nlm.nih.gov/pubmed/1324461

http://www.ncbi.nlm.nih.gov/pubmed/1649270

http://www.ncbi.nlm.nih.gov/pubmed/7761316

I bring this up for a couple of reasons:

  1. To see if anyone has encountered this in the past and, if so, if they have any guidance on other things that might be an extension of this issue
  2. To make others aware that this is something to watch out for post-therapy for Ifos

Thanks,

Brian


#2

Thanks Brian for reporting this. Are they going to do the early replacement therapy recommended in the third article? This is the first time I hear about this particular side effect of treatment but I understand that for children, there are a lot of long-term possible side effects to watch for :-(


#3

We haven't gotten as far as treatment options yet, but I will post when we have some more details.


#4

I just wanted to provide a bit of an update on this topic.


First, I'd like to apologize that my posting was based upon some information from our Oncologist which appears to have been an incorrect interpretation of his scans and tests. Very briefly, they no longer believe he has Rickets.

In general, there is still some concern about his thyroid and kidney functions (due to the radiation and Ifosfamide, respectively), but not specifically Rickets. We are still in the assessment phase and have sought a second opinion on care from Sloan Kettering as part of a 2-year checkup.


As always, thank you for your support.

Brian


#5

Keep us posted Brian and good luck!