Growth Pattern in Children of Acute Lymphoblastic Leukemia during and after Therapy

Lim, Young Tak; Bae, Sang Nam

Abstract

PURPOSE: Growth impairment and growth hormone deficiency have been reported in children treated for acute lymphoblastic leukemia (ALL). This study was undertaken to investigate the growth pattern in children who have been diagnosed and treated ALL.
METHODS
We have studied growth during 5-year period after diagnosis in 29 children with ALL who achieved complete continuous first remission following induction chemotherapy from January 1991 to December 1998 at Pusan National University Hospital. Maintenance chemotherapy was given over two or three years in all patients and 10 received additional prophylactic cranial irradiation at a total dose 1,800 to 2,000 cGy.
RESULTS
Mean age of patients at diagnosis was 5.81+/-3.44 years, mean height standard deviation score (SDS) at diagnosis was 0.58+/-0.78. During 1 st and 2 nd year of therapy, mean height SDS was significantly decreased to 0.21+/-0.78 (P<0.05), 0.26+/-0.99 (P<0.05). And these decreased mean height SDS during therapy were gradually returned to the baseline levels within 2 years after the end of therapy. During and after therapy, there were no significantly differences in changes of mean height SDS between a group who had prophylactic cranial irradiation and one who had not. There were also no significantly different changes of mean height SDS according to sex or age at initiation of treatment.
CONCLUSION
Our data indicate that chemotherapy significantly affects growth of patients treated for ALL and that effects were almost transitory, whereas radiotherapy at the doses used in this study does not potentiate growth impairment.