Growth impairment after TBI of leukemia survivors children: a model- based investigation

Area of Science:

• Pediatric Oncology
• Endocrinology
• Mathematical Modeling

Background:

• Total Body Irradiation (TBI) for Hematopoietic Stem Cell Transplantation (HSCT) poses a risk of Growth Hormone Deficiency (GHD) in children, potentially impacting Final Height (FH).
• A mathematical model was employed to analyze growth patterns, considering both standard growth trends and hormone-induced spurts, to compare TBI-affected children with a normal population.

Purpose of the Study:

• To evaluate the impact of TBI on longitudinal growth in pediatric leukemia survivors.
• To validate a novel method for estimating the effects of Growth Hormone (GH) therapy.
• To compare growth parameter values in children undergoing TBI with those of a matched normal population.

Main Methods:

• Retrospective analysis of 25 long-term survivors of childhood acute leukemia treated at Regina Margherita Children's Hospital.
• Assessment of longitudinal growth and the influence of TBI.
• Evaluation of GH therapy effects in six patients diagnosed with GHD post-TBI.

Main Results:

• TBI administered before puberty significantly impaired overall growth and pubertal duration.
• Growth limitations caused by TBI were fully reversed in the subset of children who received GH replacement therapy.
• The mathematical model demonstrated potential for accounting for therapy-induced growth spurts.

Conclusions:

• The developed mathematical model can simulate growth patterns and predict therapy effectiveness.
• The model may serve as a valuable tool for pediatricians in optimizing GH therapy timing and dosage.
• GH replacement therapy effectively counteracted TBI-induced growth impairment in the studied cohort.