Analysis of linear growth in survivors of childhood acute lymphoblastic leukemia

Therapy for childhood acute lymphoblastic leukemia (ALL) is entering a new era in terms of quality-of-life. In the current study, 21 patients with childhood-onset ALL were assessed for linear growth, bone mineral density (BMD), and endocrinological status, focusing especially on longitudinal analysi...

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Bibliographic Details
Published in:Journal of bone and mineral metabolism 2003-01, Vol.21 (3), p.172-178
Main Authors: YAMASHITA, Nobuko, TANAKA, Hiroyuki, MORIWAKE, Tadashi, NISHIUCHI, Ritsuo, ODA, Megumi, SEINO, Yoshiki
Format: Article
Language:English
Subjects:
Adolescent
Alkaline Phosphatase - metabolism
Biological and medical sciences
Biomarkers
Body Height
Bone Density
Child
Child Development
Child, Preschool
Collagen - urine
Collagen Type I
Creatinine - urine
Endocrine Glands - physiology
Female
Follow-Up Studies
Hematologic and hematopoietic diseases
Humans
Infant
Investigative techniques, diagnostic techniques (general aspects)
Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis
Linear Models
Longitudinal Studies
Male
Medical sciences
Medical treatment
Osteoarticular system. Muscles
Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques
Peptides - urine
Physical growth
Precursor Cell Lymphoblastic Leukemia-Lymphoma - physiopathology
Precursor Cell Lymphoblastic Leukemia-Lymphoma - therapy
Retrospective Studies
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Summary:Therapy for childhood acute lymphoblastic leukemia (ALL) is entering a new era in terms of quality-of-life. In the current study, 21 patients with childhood-onset ALL were assessed for linear growth, bone mineral density (BMD), and endocrinological status, focusing especially on longitudinal analysis of the growth of each patient. Linear growth was uniformly attenuated during therapy in all patients. In contrast, after the cessation of therapy, the growth of each patient varied widely from attenuated to dramatic catch-up growth. In pubertal survivors who had received chemotherapy and cranial irradiation during prepuberty, the degree of growth after the cessation of therapy was negatively correlated with changes in height Z scores during therapy ( r = -0.76, P= 0.004). One of the factors involved in catch-up growth, urinary N-telopeptide/creatinine (U-NTx/Cr), was significantly higher in patients whose Z scores decreased after cessation of therapy ( P = 0.01), despite normal pubertal development and normal endocrinological assessments. The present study revealed individual differences in linear growth after the cessation of therapy and suggests the importance of catch-up growth during puberty.
ISSN:0914-8779
1435-5604
DOI:10.1007/s007740300027