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EnglishReduction of adult height is a well-recognized complication in long-term ALL survivors who received 18 Gy or more prophylactic cranial radiotherapy (RT) during their oncological treatment in childhood. Whether changes in the pubertal timing or obesity play a role in height loss of these subjects is poorly understood. Growth patterns of 74 survivors of childhood leukaemia were analyzed: group A (16M-8F) underwent chemotherapy (CT) plus RT (18Gy); group B (30M-30F) underwent only chemotherapy. Mean age at diagnosis was 6.0±3.2yrs, mean follow-up 10.7±3yrs. Thirty-two pts (16M) had attained final height at the time of evaluation. Height (H), final height (FH), target height (TH), FH-TH, and body mass index (BMI) were evaluated at diagnosis, stop-therapy and yearly until adulthood, and converted to z scores (SD) for age and sex. Bone age (Bayley-Pinneau) and pubertal stage (Tanner) were also assessed. In group A mean FH-SD was lower than H-SD at the end of therapy (p<0.01) whereas in group B this difference was not found. FH-SD was lower (p<0.005) in group A than group B only in females. FH-TH did not differ between the two groups. The onset of puberty in groups A and B did not vary neither between girls (10.1±1.9yrs vs 10.8±0.2yrs), nor between males (12.0±1.1yrs vs 11.5±1.7yrs); mean age of menarche occurred respectively at 12.4±1.2yrs and 11.9±1yr, testicular volume ³15ml was found at 14.8±1.1yrs and 14.9±1.9yrs. Mean BMI-SD of groups A and B did not differ neither between males (0.6±1.2 vs 0.51±0.6), nor between females (-0.42±0.4 vs -0.59±1.9). Males and females submitted to cranial irradiation show a significant height loss during the follow-up, compared to subjects treated only with chemotherapy. Their growth impairment may be not detectable during the early period of follow-up, but only during the pubertal growth spurt. For this reason GH status should be reassessed in all these subjects at puberty.
| Titolo: | Growth patterns in children treated for Acute Lymphoblastic Leukemia (ALL): Relationship with cranial irradiation | |
| Autore/i: | A. Pasini; BARONIO, FEDERICO; GUALANDI, STEFANO; BAL, MILVA ORQUIDEA; M. Marsciani; MALTONI, GIULIO; CICOGNANI, ALESSANDRO | |
| Autore/i Unibo: | ||
| Anno: | 2005 | |
| Rivista: | ||
| Pagina iniziale: | 243 | |
| Pagina finale: | 243 | |
| Abstract: | Reduction of adult height is a well-recognized complication in long-term ALL survivors who received 18 Gy or more prophylactic cranial radiotherapy (RT) during their oncological treatment in childhood. Whether changes in the pubertal timing or obesity play a role in height loss of these subjects is poorly understood. Growth patterns of 74 survivors of childhood leukaemia were analyzed: group A (16M-8F) underwent chemotherapy (CT) plus RT (18Gy); group B (30M-30F) underwent only chemotherapy. Mean age at diagnosis was 6.0±3.2yrs, mean follow-up 10.7±3yrs. Thirty-two pts (16M) had attained final height at the time of evaluation. Height (H), final height (FH), target height (TH), FH-TH, and body mass index (BMI) were evaluated at diagnosis, stop-therapy and yearly until adulthood, and converted to z scores (SD) for age and sex. Bone age (Bayley-Pinneau) and pubertal stage (Tanner) were also assessed. In group A mean FH-SD was lower than H-SD at the end of therapy (p<0.01) whereas in group B this difference was not found. FH-SD was lower (p<0.005) in group A than group B only in females. FH-TH did not differ between the two groups. The onset of puberty in groups A and B did not vary neither between girls (10.1±1.9yrs vs 10.8±0.2yrs), nor between males (12.0±1.1yrs vs 11.5±1.7yrs); mean age of menarche occurred respectively at 12.4±1.2yrs and 11.9±1yr, testicular volume ³15ml was found at 14.8±1.1yrs and 14.9±1.9yrs. Mean BMI-SD of groups A and B did not differ neither between males (0.6±1.2 vs 0.51±0.6), nor between females (-0.42±0.4 vs -0.59±1.9). Males and females submitted to cranial irradiation show a significant height loss during the follow-up, compared to subjects treated only with chemotherapy. Their growth impairment may be not detectable during the early period of follow-up, but only during the pubertal growth spurt. For this reason GH status should be reassessed in all these subjects at puberty. | |
| Data prodotto definitivo in UGOV: | 27-feb-2006 | |
| Appare nelle tipologie: | 4.02 Riassunto (Abstract) |
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