Osteochondromas after Total-Body Irradiation

To the Editor: A 9-year-old boy received the diagnosis of acute biphenotypic leukemia. Once remission was induced, treatment proceeded to bone marrow transplantation with donation from the child's HLA-identical sister. The patient received total-body irradiation consisting of four fractions of 300 cGy for a total dose of 1200 cGy. The patient did well initially, but at the age of 14 years, the leukemia relapsed. At the staging workup, he was found to have bilateral osteochondromas, benign tumors composed of bone projecting from endochondral bones, in the iliac wings. On the right side, one lesion had posterior projection, and on the . . .