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Final height and growth hormone secretion after bone marrow transplantation in children
T Shinagawa1, Y Tomita, H Ishiguro
1Department of Pediatrics, Tokai University School of Medicine, Bohseidai, Kanagawa, Japan.
Insights
Children undergoing bone marrow transplantation (BMT) before age 10 risk significant growth failure. Growth hormone (GH) deficiency is not the primary cause of this impaired growth post-BMT.
Area of Science:
- Pediatric Endocrinology
- Hematology
- Oncology
Background:
- Growth hormone (GH) deficiency is a known factor in growth failure after bone marrow transplantation (BMT).
- Assessing final height and GH secretion is crucial for understanding long-term outcomes in pediatric BMT survivors.
Purpose of the Study:
- To analyze final height and GH secretion in children who received BMT.
- To determine the impact of age at BMT on growth outcomes.
- To investigate the role of GH deficiency in post-BMT growth impairment.
Main Methods:
- Retrospective analysis of final height SD scores (SDS) in 30 pediatric BMT patients.
- Evaluation of GH secretion via repeated insulin tolerance tests in 71 pediatric BMT patients.
- Comparison of growth outcomes based on age at BMT, disease type, and preconditioning regimen.
Main Results:
- Final height SDS significantly decreased post-BMT compared to pretreatment.
- Children transplanted before age 10 experienced greater height reduction.
- No patient was diagnosed with GH deficiency, though some showed transient poor GH response.
Conclusions:
- Younger age at BMT increases the risk of growth failure in children.
- GH deficiency is not a major contributor to growth impairment following BMT.
- Further research into other factors affecting post-BMT growth is warranted.
Abstract:
Growth hormone (GH) deficiency has been regarded as a principal determinant for growth failure following bone marrow transplantation (BMT). We herein analyzed final height and GH secretion in the patients who received BMT during childhood. The study on final height in 30 patients (23 males; 19 with malignant disease) who underwent BMT before or at the onset of puberty showed the following findings: (1) Final height SD score (SDS) significantly decreased compared to pretreatment height SDS. (2) Patients who underwent BMT before the age of 10 years showed significantly greater reduction in height SDS compared to those who received after the age of 10 years. (3) The type of disease or a difference in preconditioning regimen did not influence the outcome of growth. (4) No patient showed GH deficiency. The study on GH secretion included 71 patients who had been followed for more than 5 years and who underwent insulin tolerance test more than twice following BMT. Thirteen patients experienced poor GH response at least once. Two of these patients had poor GH response repeatedly. In conclusion, children who undergo BMT at younger age have a higher risk of growth failure, and GH deficiency is not a major contributing factor for growth impairment following BMT.