Growth and endocrine function after bone marrow transplantation

Shalet, Stephen M; Didi, Mohammed; Ogilvy-Stuart, Amanda; Schulga, John; Donaldson, M D C

doi:10.1111/j.1365-2265.1995.tb02640.x

Cited by 74 publications

(60 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…1,2 High rates of skeletal complications, 3 growth disturbances, 4 and thyroid 5,6 and gonadal dysfunction 7 have been described in survivors, although data on the frequency of metabolic syndrome are still sparse. 8 The relative risk of these complications is likely to be influenced by the underlying disease, previous treatments, post-BMT treatments and age at BMT.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Endocrine dysfunction and parameters of the metabolic syndrome after bone marrow transplantation during childhood and adolescence

Shalitin

Phillip

Stein

et al. 2006

Bone Marrow Transplant

View full text Add to dashboard Cite

Endocrine dysfunction and parameters of metabolic syndrome were assessed in 91 patients aged 4.3-32.5 years who underwent allogeneic or autologous BMT in childhood. Final short stature, found in five of the 35 patients who attained final height, was associated with the underlying disease (specifically, Fanconi anemia) (P ¼ 0.0013), previous cranial irradiation (P ¼ 0.0007), type of conditioning irradiation (Po0.05) and allogeneic BMT (P ¼ 0.05). Growth hormone deficiency (n ¼ 10) was associated with previous cranial irradiation (Po0.005) and conditioning total body irradiation (Po0.001). Twelve patients had primary hypothyroidism, one had hyperthyroidism and one papillary thyroid carcinoma. Hypothyroidism was associated with neck/mediastinal (Po0.005) and conditioning irradiation (Po0.05). Primary gonadal failure was found in 24 of the mature patients (62.5% females). Hypogonadism was associated with the underlying disease (especially hematological malignancies) (Po0.05), pretransplant treatment (Po0.05), irradiation conditioning (Po0.001), older age (Po0.005) and advanced pubertal stage at BMT (Po0.05). Obesity (body mass index 42 s.d.) was found in 4.4% and type II diabetes and impaired glucose tolerance in 3.3% each. Dyslipidemia was found in 27.9% of the 43 patients tested. These findings emphasize the need for long-term follow-up of endocrine and metabolic parameters in young patients after BMT in order to offer proper treatment and improve quality of life.

show abstract

Section: Introductionmentioning

confidence: 99%

“…8 The relative risk of these complications is likely to be influenced by the underlying disease, previous treatments, post-BMT treatments and age at BMT. 7 In both children and adults, attention is now being focused on these late complications, which may affect health and lower their quality of life.…”

Section: Introductionmentioning

confidence: 99%

Endocrine dysfunction and parameters of the metabolic syndrome after bone marrow transplantation during childhood and adolescence

Shalitin

Phillip

Stein

et al. 2006

Bone Marrow Transplant

View full text Add to dashboard Cite

show abstract

“…13,14 Impaired growth hormone secretion is frequent after cranial or total body irradiation for childhood cancer. 15,16 Growth hormone deficient children 17 and adults 18 are adipose, also when matched for BMI. Consequently, BMI is a less valid measure of adiposity in survivors of childhood cancer than in the background population.…”

mentioning

confidence: 99%

Degree of fatness after allogeneic BMT for childhood leukaemia or lymphoma

Nysom

Holm

Michaelsen

et al. 2001

Bone Marrow Transplant

View full text Add to dashboard Cite

Summary:Excess fatness is frequent after childhood ALL treated without BMT. We measured the whole-body percent fat by dual-energy X-ray absorptiometry and the bodymass index (weight/height 2 (kg/m 2 ), BMI) in 25 survivors of childhood leukaemia or lymphoma (21 with ALL) who had received TBI and allogeneic BMT a median of 8 years ago (range 4-13). Adjusted for sex and age, the mean BMI was slightly but significantly reduced (0.4 s.d. below predicted) and the whole-body percent fat was significantly increased compared with healthy controls (1.1 s.d. above predicted). Eleven of 25 patients had a percent fat above the 90 percentile of the reference values, which indicates excess fatness. Adjusted for sex and age, a higher percent fat was related to additional cranial irradiation. Controlled for this, the whole-body percent fat seemed to be unrelated to age at BMT, length of follow-up, and previous chemotherapy. Compared with untransplanted ALL survivors treated with cranial irradiation, BMT survivors had significantly reduced BMI but similar whole body percent fat. BMI was a poor measure of body fatness in these patients. In conclusion, survivors of BMT for childhood leukaemia or lymphoma are adipose and slightly underweight and consequently have a substantially reduced lean body mass. Bone Marrow Transplantation (2001) 27, 817-820. Keywords: leukaemia; lymphoma; childhood; late sideeffects of therapy; body-mass index; body composition During the last decades the survival rates after childhood leukaemia and lymphoma have risen considerably. 1 For children with very high risk 2 or relapsed disease, 3-5 allogeneic BMT with a related donor will give the highest chance of survival. Unfortunately, allogeneic BMT for childhood cancer has frequent and severe delayed side-effects.Body-mass index (weight/height 2 (kg/m 2 ), BMI) is considered the best available weight-stature index in both chil- dren and adults, regarding independence of stature, correlation with body fat, and prediction of mortality. 6 Raised BMI (overweight) in childhood and adolescence increases the risk of being overweight in adulthood, 7,8 and overweight in adolescence 9 and adulthood 10,11 is associated with excess morbidity and mortality. In industrialised countries, the frequency of overweight people has increased over the last decades. 12 Whole-body dual-energy X-ray absorptiometry (DXA) is currently considered the most valid practically usable method for non-invasively measuring the body composition according to a three-compartment model based on bone mineral mass, fat mass, and non-fat non-mineral mass. 13,14 Impaired growth hormone secretion is frequent after cranial or total body irradiation for childhood cancer. 15,16 Growth hormone deficient children 17 and adults 18 are adipose, also when matched for BMI. Consequently, BMI is a less valid measure of adiposity in survivors of childhood cancer than in the background population. The BMI [19][20][21][22][23][24][25] and the degree of fatness 25-27 after childhood ALL treated without BMT have bee...

show abstract

“…cyclophosphamide) and total body irradiation. Irradiation will affect both Leydig cells and Radford et al, 1994 (Doxorubicin, cyclophosphamide, etoposide, vincristine, bleomycin and prednisolone) germinal epithelium, while cytotoxic chemotherapy in the adult will affect the germinal epithelium leading to a high prevalence of adult male infertility and gonadal dysfunction (Shalet et al, 1995). Two out of 8 boys at a mean of 2 .…”

Section: Chemotherapymentioning

confidence: 99%