Background: Long-term survivors of childhood acute leukaemia can suffer from growth impairment. The purpose of this study was to evaluate longitudinal growth and final height of paediatric patients who were treated with acute leukaemia and factors that can cause growth impairment.
Methods: Of 234 patients (133 males and 101 females) who were diagnosed as acute lymphoblastic leukaemia (ALL; n=162) or acute myeloblastic leukaemia (AML; n=72) before age 18 between June 1996 and June 2009, 112 patients (65 males and 47 females). The mean age at enrolment was 19.2±2.6 years. Among them, 59 patients treated with chemotherapy only and 53 patients received hematopoietic stem cell transplantation (HSCT). We reviewed height S.D. scores from diagnosis to final height and risk factors such as sex, age at diagnosis, diagnosis, pubertal status at diagnosis, radiation and chronic graft-versus-host-disease (cGVHD) that can affect growth were evaluated.
Results: The mean height S.D.s at diagnosis of 112 patients was 0.19±1.11 and the mean final height S.D.s was −0.89±1.31. The mean height S.D.s from the diagnosis to their final height were significantly decreased (Δheight S.D.s=−1.08±1.12, P<0.001). The height loss was more severe in the patients who received HSCT than the patients who received chemotherapy only (−0.81±0.87 vs −1.38±1.29, P=0.008). In chemotherapy only patients (n=59), the changes in height S.D.s from the diagnosis to final height were positively correlated with age at diagnosis (r=0.117, P<0.001) and negatively correlated with pubertal state at diagnosis (r=−0.474, P=0.039) and cranial irradiation (r=−0.716, P=0.022). In multiple regression analysis, younger age at diagnosis was the only significant risk factor of loss in final height in chemotherapy group (P=0.008). In HSCT patients (n=53), the differences of height S.D.s between at diagnosis and final height were showed positive correlation with age at diagnosis (r=0.177, P<0.001) and negative correlation with pubertal status at diagnosis (r=−1.197, P=0.001) and total body irradiation (TBI) for conditioning (r=−1.192, P<0.001). In multiple regression analysis, younger age at diagnosis was significant risk factors cause loss of final height in HSCT patients (P=0.002).
Conclusions: The loss of final height in survivors of childhood acute leukaemia was significantly related with younger age at diagnosis.
01 - 03 Oct 2015
European Society for Paediatric Endocrinology