Growth Patterns in Patients with Acute Leukemia after Allogeneic Stem Cell Transplantation

Chueh, Hee Won; Lee, Soo Hyun; Yoo, Keon Hee; Sung, Ki Woong; Koo, Hong Hoe

Abstract

BACKGROUND
Growth of the children who received allogeneic stem cell transplantation (allo-SCT) is known to be impaired. We analyzed the patterns of growth in long-term survivors of acute leukemia who are disease free more than 5 years after allo-SCT.
METHODS
Heights and weights of 55 patients with acute leukemia who received allo-SCT between January 1999 and December 2005 in Samsung Medical Center, and who are alive without disease, were assessed. Heights and weights of the patients' parents were assessed to compare with the patients' growth.
RESULTS
24 patients with acute lymphoblastic leukemia, 5 patients with acute biphenotypic leukemia, and 26 patients with acute myeloid leukemia have been followed up during 97 months (63-176 months). All patients had decreased final height Z-score and weight Z-score (height, male, -1.273 (-2.383-1.53), female -0.871 (-2.398-0.827), weight, -0.976 (-4.532-2.706) and -0.949 (-3.695-1.856), respectively). Final height of 23 patients aged over 18 was 165.0 cm (157.1-174.9) in male, and 156.9 cm (149.2-165.1) in female patients. Final height was decreased compared to their mid-parental height (male, 171.0 cm (167.5-178.0 cm), P=0.003, female, 160.0 cm (156.0-161.0 cm), P=0.460). Total body irradiation (TBI) and age at diagnosis was the risk factor for decreased final height. But others didn't affect to adult height. Nineteen (34.5%) patients have been treated for various endocrine problem, and 12 (21.8%) had other complications.
CONCLUSION
Patients with acute leukemia treated with allo-SCT had decrease in final growth, and had many other medical problems. Further efforts to evaluate and manage these problems are desperately needed.