Analysis of linear growth in survivors of childhood acute lymphoblastic leukemia

• 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
• ISSN: 0914-8779; 1435-5604
• DOI: 10.1007/s007740300027

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.