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Avascular Necrosis of the Femoral Head with Combination Therapy

DONALD L. SWEET Jr., M.D.; DANIEL G. ROTH, M.D.; RICHARD K. DESSER, M.D.; J. BRUCE MILLER, M.D.; and JOHN E. ULTMANN, M.D., F.A.C.P.
[+] Article and Author Information

Grant support: in part by U.S. Public Health Training Grant No. T32-AM 07134-01 and National Cancer Institute Grant 5 P30 CA 14599-03. The Franklin McLean Memorial Research Institute is operated by the University of Chicago for the U.S. Energy Research and Development Administration under Contract No. E(11-1)-69.

▸Requests for reprints should be addressed to John E. Ultmann, M.D.; Box 444, 950 East 59 Street; Chicago, IL 60637.


Chicago, Illinois


Ann Intern Med. 1976;85(1):67-68. doi:10.7326/0003-4819-85-1-67
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Four patients with malignant lymphoma who were treated with multiple courses of combination chemotherapy, consisting of cyclophosphamide, Oncovin®, procarbazine, and prednisone (COPP), developed avascular necrosis of the femoral head(s). Disorders usually associated with the development of avascular necrosis were absent. The total prednisone dose received by each patient was small. Avascular necrosis of the femoral head should be considered in the differential diagnosis of bone pain in patients receiving multiple courses of combination chemotherapy.

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