Changes in height, weight and plasma leptin after bone marrow transplantation

Area of Science:

• Endocrinology
• Pediatric Oncology
• Hematology

Background:

• Short stature is a significant side effect of bone marrow transplantation (BMT).
• Weight changes impact growth rate and insulin-like growth factor (IGF-I) levels.
• Understanding the long-term effects of different irradiation protocols on growth is crucial.

Purpose of the Study:

• To analyze changes in height and body mass index (BMI) in patients following BMT.
• To investigate the impact of different irradiation regimens on growth hormone (GH) and IGF-I levels.
• To explore the relationship between BMI, leptin, and GH secretion post-BMT.

Main Methods:

• Retrospective analysis of 53 patients undergoing BMT.
• Categorization into groups based on treatment: fractionated TBI, single-dose TBI, total lymphoid irradiation, or chemotherapy alone.
• Measurement of height, BMI, plasma IGF-I, GH peaks, and leptin concentrations at various time points post-BMT.

Main Results:

• Patients receiving total body irradiation (TBI) exhibited lower IGF-I levels compared to those receiving total lymphoid irradiation or chemotherapy alone.
• A significant proportion of TBI patients had below-average BMI at 2 and 5 years post-BMT.
• BMI and leptin concentrations correlated positively, and both correlated negatively with GH peak, suggesting a potential hypothalamic-pituitary lesion.

Conclusions:

• Total body irradiation (TBI) appears to decrease GH secretion and is associated with persistent low BMI after BMT.
• The observed negative correlation between GH peak and leptin may indicate TBI-induced damage to the hypothalamic-pituitary axis.
• Further research is warranted to elucidate the mechanisms behind TBI-related growth disturbances.