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[Physical development in patients with acute lymphoblastic leukemia in childhood]
1I. dĕtská klinika LF Masarykovy univerzity, Brno.
Insights
Childhood acute lymphoblastic leukaemia (ALL) survivors often experience average or reduced height and a tendency towards obesity. Impaired growth is more common in those diagnosed younger or with shorter post-therapy intervals.
Area of Science:
- Pediatric Oncology
- Endocrinology
- Hematology
Context:
- Childhood acute lymphoblastic leukaemia (ALL) is a common pediatric cancer.
- Treatment for ALL can lead to long-term health issues, including impaired growth.
- Understanding these sequelae is crucial for comprehensive patient care.
Purpose:
- To investigate the long-term effects of ALL treatment on growth and body composition.
- To analyze the correlation between treatment protocols (Pinkel's vs. BMF) and growth outcomes.
- To identify factors influencing impaired growth in ALL survivors.
Summary:
- This study followed 63 childhood ALL survivors treated with Pinkel's or BMF protocols.
- Growth (height, proportionality) and obesity tendencies were assessed post-therapy.
- No strong correlation was found with cumulative chemotherapy doses or radiotherapy, but impaired growth was linked to younger diagnosis age (<3 years) and shorter time since therapy completion.
Impact:
- Findings highlight the need for monitoring growth and metabolic health in ALL survivors.
- Informs clinical practice regarding risk stratification for growth impairment.
- Contributes to long-term survivorship research in pediatric oncology.
Abstract:
Acute lymphoblastic leukaemia (ALL) is one of the readily treatable neoplastic diseases of childhood. One of the late sequelae of treatment can be impaired growth. The authors followed up therefore a group of 63 patients where during childhood a diagnosis of ALL was made. The investigated group was treated according to two fundamental protocols--according to Pinkel's protocol and according to BMF protocols. All patients treated according to Pinkel's protocol had, as part of prevention of leukaemia of the CNS, radiotherapy of the skull, patients treated according to the BMF protocol only when the risk factor was higher than 0.8. The authors investigated in their patients the height and proportionality after termination of all antileukaemic therapy. They found that the height of children, adolescents and adults who suffered from ALL during childhood is average or less. A tendency towards obesity is typical. The authors did not observe a correlation with the total cumulative doses of cytostatics nor a marked correlation with radiotherapy. Impaired growth was more frequent when ALL was diagnosed before the age of 3 years and where the interval after completed therapy was shorter.