[Late effects of chemo- and radiotherapy in two children treated for acute lymphoblastic leukemia]

The endocrinological disorders are known sequelae of cancer therapy. The aim of our study was to evaluate the effects of chemo- and radiotherapy on growth and auxiological parameters in children treated for acute lymphoblastic leukaemia (ALL) since 1984 to 1996. We studied growth, pubertal development and endocrine functions in 32 patients who were treated for ALL. Two of them had endocrine abnormalities. Both took a different course of disease and treatment because of local relapse in uterus (the girl) and in testis (the boy). All patients received cranial preventive radiotherapy but two of them also received: abdominal irradiation (the girl) and direct testicular irradiation (the boy) with total doses 24 Gy. The girl had clinical and biochemical symptoms of primary thyroid failure, growth hormone deficiency and hypergonadotropic hypogonadism recognized after 8 years following the completion of therapy. The boy had biochemical symptoms of hypogonadism with low serum testosterone concentration responses to stimulation with human gonadotropin after 4 years of remission.

We suggest that clinical and biochemical assessment of endocrinological functions including growth, pubertal development, thyroid function should be performed at regular intervals following chemotherapy and radiotherapy in patients with acute lymphoblastic leukaemia and another carcinomas.