Longitudinal growth and final height in long-term survivors of childhood leukaemia

Abstract

Survival of children with acute lymphoblastic leukaemia (ALL) has increased considerably in recent years and data on the spontaneous growth and final height of these children are conflicting. Therefore, we analysed the longitudinal growth and final height in 52 survivors (33 females, 19 males) of childhood ALL. These children were diagnosed and treated in a single institution, all remained in first remission and were submitted to cranial irradiation with either 2400 or 1800 cGy. None of the patients received testicular or spinal irradiation. Median age at diagnosis was 4.2 (range 1.3-9.6) years in the first group (2400 cGy) and 3.9 (0.8-10.5) years in the second (1800 cGy). Standing height was measured at diagnosis, at the end of treatment (median 3.1 years after diagnosis), 6, 12, 24 months after the end of treatment, and finally at the completion of growth. In girls a significant decrease of mean height standard deviation score (SDS) during treatment and a catch up in growth after the end of therapy was followed by a second period of reduced growth. Mean final height SDS was significantly lower than the value at diagnosis in both groups of girls, but only in males treated with 2400 cGy. Mean overall loss in height SDS from diagnosis to final height was higher in females (-1.24) than in males (-0.40) (P = 0.009). Females < or = 4 years of age at diagnosis showed a higher loss in final height than females > 4 years.(ABSTRACT TRUNCATED AT 250 WORDS)

Nutritional assessment and serum zinc and copper concentration among children with acute lymphocytic leukemia: a longitudinal study

“…30,31 In our study, we observed growth retardation du ring treatment mainly among the children who received cranial irradiation. One cause of the growth retardation in patients with ALL is thought to be cranial irradiation, which affects growth hormone secretion, among other results.…”

Final height and puberty in 40 patients after antileukaemic treatment during childhood

“…Several reports had shown that early puberty in children with ALL might be another factor resulting in reduced final height [5,29,30]. Although in this study pubertal stages, testicular volume or bone age were not routinely documented, pubertal growth spurt and menarche were available for estimation of puberty.…”

Obesity in patients with acute lymphoblastic leukemia in childhood

“…Moreover, the gender-dependence of effects of irradiation could be related to different age of cerebral development and vulnerability of the nervous structure in boys and girls. According to this, irradiated ALL survivor girls seemed to be particularly affected by precocious puberty and to have experienced greater growth impairment than boys [25,26]. The study conducted by Oeffinger and colleagues achieved similar results, even if they detected an opposite and direct dose-dependent radiotherapy-effect.…”