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Updated: Aug 11, 2026
Competitive Transplants to Evaluate Hematopoietic Stem Cell Fitness
Published on: August 31, 2016
Growth-chart-based qualitative evaluation of height growth after hematopoietic stem cell transplantation
Satoshi Narumi1, Hiroyuki Shimada, Noriko Shimasaki
1Department of Pediatrics, Keio University School of Medicine, Shinanomachi, Tokyo, Japan.
Insights
Hematopoietic stem cell transplantation (SCT) can cause growth failure in children. Analyzing growth charts helps categorize patients into early or late-onset growth retardation for individualized follow-up and treatment.
Area of Science:
- Pediatric Endocrinology
- Hematology
- Oncology
Background:
- Growth failure is a significant complication in pediatric patients post-hematopoietic stem cell transplantation (SCT).
- Effective monitoring and stratification of growth patterns are crucial for optimizing patient outcomes.
Observation:
- A qualitative method using growth charts was employed to evaluate height growth after SCT.
- Patients were categorized into normal growth, early-onset growth retardation (E-group, within 1 year post-SCT), and late-onset growth retardation (L-group, >1 year post-SCT).
Findings:
- In the E-group, total body irradiation and prolonged steroid therapy were implicated in growth failure.
- In the L-group, impaired pubertal development was identified as the primary cause of growth retardation.
- The L-group's growth pattern is clinically significant, offering potential for improved final stature through pharmacological intervention.
Implications:
- Growth chart analysis provides a valuable tool for stratifying children with post-SCT growth issues.
- Individualized follow-up and treatment strategies can be developed based on growth chart patterns.
- Targeted interventions, particularly for late-onset growth retardation, may enhance final adult height in pediatric SCT survivors.
Abstract:
Growth failure is one of the most common late complications in children undergoing hematopoietic stem cell transplantation (SCT). The present report describes a qualitative method of evaluating height growth after SCT, using a growth chart. The patients were divided into three groups according to the shape of their growth chart: the normal growth chart group, the early-onset growth retardation group (E-group), in which a decreased growth rate was seen during the first year after SCT, and the late-onset growth retardation group (L-group), in which a decreased growth rate was seen more than 1 yr after the SCT. In the E-group, total body irradiation and prolonged steroid therapy were thought to contribute to the growth failure, whereas in the L-group, impaired pubertal development was thought to be responsible. The growth pattern in the L-group may, therefore, be of particular clinical importance, because the final stature of the subjects in this group can be improved by pharmacological adjustment of pubertal onset. Although limited by the small size and heterogeneous nature of the sample, our results suggest that growth-chart-based evaluation may provide important information to stratify subjects showing inadequate growth after SCT into two groups whose follow-up and treatment should be individualized.
