Longitudinal Linear Growth and Final Height is Impaired in Childhood Acute Lymphoblastic Leukemia Survivors after Treatment without Cranial Irradiation

Vandecruys, Els; Dhooge, Catharina; Craen, Margarita; Benoît, Yves; Schepper, Jean De

doi:10.1016/j.jpeds.2012.12.037

Cited by 29 publications

(26 citation statements)

References 20 publications

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“…We evaluated the longitudinal changes in height z scores, which decreased during therapy and improved after its completion. Previous studies have demonstrated that patients receiving chemotherapy without cranial irradiation can catch up with respect to their height z scores after completing therapy . It is important to note that we found that the median height z scores of patients aged ≥10 years at the time of diagnosis were higher than those of patients aged 2 to <10 years at the time of diagnosis until the early phase of continuation therapy but demonstrated no improvement after therapy, and at 5 years off therapy had become lower than those of patients aged 2 to <10 years at the time of diagnosis.…”

Section: Discussioncontrasting

confidence: 53%

“…Childhood obesity is prevalent in the United States (17.0% of US children were reported to be obese from 2011‐2014); however, children with ALL are at an increased risk of becoming overweight or obese, which can result in substantial physical and psychosocial morbidity and further complicate other therapy‐associated adverse effects, such as infections, osteopenia, and osteonecrosis . Reductions in linear growth and final adult height are well‐known complications of ALL treatment, especially that involving cranial irradiation, which can cause hypothalamic‐pituitary dysfunction . To the best of our knowledge, data regarding obesity and linear growth in children with ALL who are treated uniformly on a single contemporary protocol without cranial irradiation are limited.…”

Section: Introductionmentioning

confidence: 99%

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Changes in body mass index, height, and weight in children during and after therapy for acute lymphoblastic leukemia

Browne

Zhou

Chemaitilly

et al. 2018

Cancer

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BACKGROUND: Children with acute lymphoblastic leukemia (ALL) have increased risk for obesity and short stature. Data on patients treated on contemporary protocols without cranial irradiation are limited. METHODS: Changes in body mass index (BMI), height, and weight Z-scores from diagnosis to 5 years off therapy were evaluated with multivariable analysis in 372 children with ALL (aged 2–18 years at diagnosis) enrolled on the St. Jude Total XV protocol in 2000–2007. RESULTS: The percentage of overweight/obese patients increased from 25.5% at diagnosis to approximately 50% during the off-therapy period. Median BMI Z-scores increased significantly during glucocorticoid therapy (induction [Δ0.56; P<0.001, 95% confidence interval [CI]: 0.29–0.64] and re-induction II [Δ0.22; P=0.001, 95% CI: 0.13–0.49]) and during the first year post-therapy (Δ0.18; P=0.006, 95% CI: 0.08–0.46). Among patients who were of healthy weight/underweight at diagnosis, those aged 2 to <10 years at diagnosis had a significantly higher risk of becoming overweight/obese during or after therapy than did those aged ≥10 years (P=0.001). Height Z-scores declined during treatment and improved post-therapy. Age 2 to <10 years at diagnosis, low-risk status, white blood cell count (WBC) < 50×109/L at diagnosis, and negative central nervous system (CNS) disease were associated with significantly better improvement in height Z-scores during the off-therapy period than were age ≥10 years, standard/high-risk status, WBC ≥ 50×109/L, and positive CNS disease, respectively. CONCLUSIONS: Obesity was prevalent, and height growth, especially in patients with identified risk factors, was compromised. Multidisciplinary intervention should begin during induction therapy and continue during the off-therapy period.

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Section: Discussioncontrasting

confidence: 53%

Section: Introductionmentioning

confidence: 99%

Changes in body mass index, height, and weight in children during and after therapy for acute lymphoblastic leukemia

Browne

Zhou

Chemaitilly

et al. 2018

Cancer

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“…While adult height is reported to be within 2 SD of the mean in most CCS of acute leukemia treated with chemotherapy only [46, 48, 50], Chow et al [6] found a 3-fold increased risk of short adult height among all survivors treated for acute leukemia without RT relative to the sibling control group, with an increased risk of short adult height among female survivors. While there are reports of GHD among CCS treated with chemotherapy only [51, 52], these findings remain controversial.…”

Section: Growth Impairment and Short Adult Height In Ccs Treated Withmentioning

confidence: 99%

Growth Disturbances in Childhood Cancer Survivors

Antal

Balachandar

2019

Horm Res Paediatr

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Survival from childhood cancer has improved dramatically over the last few decades, resulting in an increased need to address the long-term follow-up and care of childhood cancer survivors. Appropriate linear growth is an important measure of health, with alterations of growth in children and short adult height in those who have completed growth serving as potential indicators of the sequelae of the underlying diagnosis or the cancer treatments. It is therefore critical that clinicians, particularly endocrinologists, be familiar with the patterns of altered growth which may be seen following diagnosis and treatment for childhood cancer. In this article, we will review the growth alterations seen in childhood cancer survivors, focusing on risk factors and considerations in evaluation and care.

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“…Growth retardation and relative growth hormone deficiency are common during ALL therapy, but usually an adequate growth catch-up is obtained after cessation of therapy in children who do not receive radiotherapy 105, 106 , but with a trend toward reduced final height 107 .…”

Section: Endocrinopathiesmentioning

confidence: 99%

Non-infectious chemotherapy-associated acute toxicities during childhood acute lymphoblastic leukemia therapy

et al. 2017

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During chemotherapy for childhood acute lymphoblastic leukemia, all organs can be affected by severe acute side effects, the most common being opportunistic infections, mucositis, central or peripheral neuropathy (or both), bone toxicities (including osteonecrosis), thromboembolism, sinusoidal obstruction syndrome, endocrinopathies (especially steroid-induced adrenal insufficiency and hyperglycemia), high-dose methotrexate-induced nephrotoxicity, asparaginase-associated hypersensitivity, pancreatitis, and hyperlipidemia. Few of the non-infectious acute toxicities are associated with clinically useful risk factors, and across study groups there has been wide diversity in toxicity definitions, capture strategies, and reporting, thus hampering meaningful comparisons of toxicity incidences for different leukemia protocols. Since treatment of acute lymphoblastic leukemia now yields 5-year overall survival rates above 90%, there is a need for strategies for assessing the burden of toxicities in the overall evaluation of anti-leukemic therapy programs.

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Longitudinal Linear Growth and Final Height is Impaired in Childhood Acute Lymphoblastic Leukemia Survivors after Treatment without Cranial Irradiation

Cited by 29 publications

References 20 publications

Changes in body mass index, height, and weight in children during and after therapy for acute lymphoblastic leukemia

Changes in body mass index, height, and weight in children during and after therapy for acute lymphoblastic leukemia

Growth Disturbances in Childhood Cancer Survivors

Non-infectious chemotherapy-associated acute toxicities during childhood acute lymphoblastic leukemia therapy

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