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Published on: September 18, 2013
Height of children off therapy after acute lymphoblastic leukemia
M G Zurlo1, E Senesi, B Terracini
1Department of Pediatrics, Ospedale S. Gerardo, Monza, Italy.
Insights
Children treated for acute lymphoblastic leukemia (ALL) experienced a significant decrease in height percentiles post-therapy. This impact on stature was more pronounced in girls and those who received radiotherapy.
Area of Science:
- Pediatric Oncology
- Endocrinology
- Clinical Genetics
Background:
- Childhood acute lymphoblastic leukemia (ALL) treatment involves intensive multidrug chemotherapy and, in some cases, cranial radiotherapy.
- Survivors of childhood ALL often face long-term health issues, including growth disturbances.
Purpose of the Study:
- To evaluate the long-term impact of ALL treatment on the final height of childhood survivors.
- To identify factors influencing growth impairment in ALL survivors.
Main Methods:
- Retrospective analysis of height data from 290 children in continuous complete remission for at least 2 years post-ALL therapy.
- Comparison of height percentiles at diagnosis, post-therapy, and against expected growth patterns.
- Stratification of results by sex and treatment modalities, including radiotherapy and intrathecal drug administration.
Main Results:
- A significant downward shift in height percentiles was observed in ALL survivors compared to expected growth (p < 0.001).
- Girls exhibited a more pronounced reduction in height percentiles than boys.
- Short stature was particularly evident in pubertal girls and patients who received radiotherapy.
Conclusions:
- Childhood ALL treatment, especially with radiotherapy, can lead to significant long-term growth impairment, particularly in girls.
- Long-term endocrine and growth monitoring is crucial for survivors of childhood ALL.
- Further research into optimizing treatment protocols to mitigate growth-related side effects is warranted.
Abstract:
A total of 290 children off therapy after acute lymphoblastic leukemia, in continuous complete remission for at least 2 years, were evaluated for height at the onset of the disease and at the most recent clinical visit (median time after suspension of treatment 4 years 4 months, range 2 years-11 years 3 months). All patients had been treated with multidrug schedules; intrathecal drugs had been given to 84% of the patients for prevention of CNS involvement, associated with radiotherapy. The height percentiles at the most recent examination were shifted downward significantly compared with the expected pattern (p less than 0.001). The effect on stature was much more marked in girls, with a reduction of height percentiles at most recent examination from expected and from diagnosis; in males there was a reduction from diagnosis to latest follow-up, but the values were within the limits of normal. The short stature was mostly observed in pubertal girls and in patients who had undergone radiotherapy.
