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Summary: Osteonecrosis (ON) is a common complication of glucocorticoid‐based Hodgkin lymphoma (HL) treatment, but the natural evolution and prognosis of ON lesions remain poorly understood. We describe the radiological evolution of ON lesions identified in a Nordic population‐based cohort of paediatric HL patients. Magnetic resonance images of suspected ON lesions were centrally reviewed to confirm ON diagnosis and grade the ON lesions according to the Niinimäki classification. The study included 202 ON lesions in 46 patients, of which 77 were joint lesions. Follow‐up images were available for 146/202 lesions, with a mean follow‐up time of 28 months. During follow‐up, 71% of the lesions remained stable, 26% improved or resolved, and 3% progressed. A higher ON grade at diagnosis was associated with a lower likelihood of spontaneous resolution. The likelihood for resolution of ON decreased by 50% for each year of added patient age, when adjusted for sex, ON location, and symptoms. Hip ON showed less spontaneous improvement compared with other joints, and the risk for surgery was 13‐fold in hip ON. Grades 3–4 joint ON has the potential to either progress or resolve, warranting follow‐up in patients with severe symptoms. Research on secondary prevention should be directed at grade 3–4 joint ON. [ABSTRACT FROM AUTHOR]

Response to mitogen-activated protein kinase inhibition of neurodegeneration in Langerhans cell histiocytosis monitored by cerebrospinal fluid neurofilament light as a biomarker: a pilot study Keywords: Langerhans cell histiocytosis; central nervous system; neurodegeneration; mitogen-activated protein kinase inhibition; neurofilament light chain protein EN Langerhans cell histiocytosis central nervous system neurodegeneration mitogen-activated protein kinase inhibition neurofilament light chain protein 248 254 7 12/27/21 20220101 NES 220101 Langerhans cell histiocytosis (LCH) is an inflammatory myeloid neoplasia with highly variable clinical presentation.1 Granulomatous lesions of bone, skin, and lungs (particularly in adults) are most common, but the liver, spleen, bone marrow, and central nervous system (CNS) may also be affected.1 CNS involvement (CNS LCH) often causes endocrinopathies, most commonly diabetes insipidus (DI), but may also cause a debilitating slowly-progressive neurodegeneration.1,2 Notably, a population-based study reported that at least 24% of all children with LCH develop signs of neurodegenerative CNS LCH (ND-CNS-LCH) on magnetic resonance imaging (MRI).3 Thus, a strategy for early detection, treatment, and monitoring of ND-CNS-LCH is imperative. Central nervous system, neurodegeneration, Langerhans cell histiocytosis, mitogen-activated protein kinase inhibition, neurofilament light chain protein GLO:1XW/01jan22:bjh17781-fig-0001.jpg PHOTO (COLOR): 1 Neurofilament (NFL) levels in the cerebrospinal fluid (CSF) in the five children with central nervous system (CNS) affection of Langerhans cell histiocytosis (LCH) before and after initiation of treatment with mitogen-activated protein kinase pathway inhibitors (MAPKi). [Extracted from the article]