Final height and body mass index in adult survivors of childhood acute lymphoblastic leukemia treated without cranial radiotherapy: a retrospective longitudinal multicenter Italian studyReport as inadecuate




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BMC Pediatrics

, 14:236

General pediatric medicine and surgery

Abstract

BackgroundYoung adult survivors of childhood acute lymphoblastic leukemia ALL treated with protocols including cranial radiotherapy demonstrate a persistent weight gain and reduced final height. Published reports on the effects on growth of different oncologic therapies are conflicting and difficult to interpret because they combined children treated with both cranial irradiation and multi-agent chemotherapy. Our study investigated the effect of chemotherapy alone on body mass index BMI and on growth at the achievement of final height in a homogeneous cohort of Italian childhood ALL survivors.

MethodsWe retrospectively studied 162 Caucasian patients treated on the Italian Association of Pediatric Hematology and Oncology protocols without radiotherapy between 1989 and 2000 at five Italian centers with 107 inclusions 58 males. Height- and BMI-standard deviation score SDS were collected at diagnosis of ALL, at the end of treatment and at the achievement of final height. Changes in height SDS and BMI SDS with time were analyzed using dependent sample Student-s t-test.

ResultsA significant reduction of height-SDS was documented during treatment in both genders. This reduction of height-SDS was not followed by an appropriate catch-up growth, despite the achievement of a mean final height within the normal range. At diagnosis females showed a lower mean BMI-SDS than males. During treatment, in the whole population, BMI-SDS increased significantly. After it, while males lost BMI-SDS, females showed its persistent increase.

ConclusionsSurvivors of childhood ALL generally seemed to achieve a normal final height with a BMI within the normal range. These parameters appeared to be only minimally affected by chemotherapy. Nevertheless, height catch-up growth was not completed after chemotherapy in both genders and all patients experienced an increase of BMI-SDS during chemotherapy that only females seemed to conserve until the achievement of final height.

AbbreviationsADMAdriamycin

AIEOPItalian Association of Pediatric Hematology and Oncology

ALLAcute Lymphoblastic Leukemia

ARA-CCytosine arabinoside

BMIBody Mass Index

CPMCyclophosphamide

DESADexamethasone

DNMDaunorubicin

EoTEnd of Treatment

FHFinal Height

GHGrowth Hormone

IFOIfosfamide

ITIntrathecal

IVIntravenously

L-ASPL-asparaginase

MTXMethotrexate

PDNprednisolone

SDDeviation Score

SDSStandard Deviation Score

sTdiagnosis of ALL

THTarget Height

VCRVincristine

VM-26teniposide

WBCWhite Blood Cells

6-MP6-mercatopurine

6-TG6-thioguanine.

Electronic supplementary materialThe online version of this article doi:10.1186-1471-2431-14-236 contains supplementary material, which is available to authorized users.

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Author: Patrizia Bruzzi - Barbara Predieri - Andrea Corrias - Alberto Marsciani - Maria Elisabeth Street - Aurora Rossidivita - Pao

Source: https://link.springer.com/







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