Growth in children following irradiation for bone marrow transplantation

Journal Article · · Am. J. Pediatr. Hematol./Oncol.; (United States)

OSTI ID:5815756

Bushhouse, S; Ramsay, N K; Pescovitz, O H; Kim, T; Robison, L L

Longitudinal height data from 46 pediatric bone marrow transplant (BMT) patients, including 18 with aplastic anemia (AA), 19 with acute nonlymphoblastic leukemia (ANLL), and 9 with acute lymphoblastic leukemia (ALL), were analyzed to assess growth posttransplantation. Patients were prepared for BMT with high-dose cyclophosphamide followed by 7.5 Gy single-dose irradiation; AA patients received total lymphoid irradiation (TLI), and leukemia patients received total body irradiation (TBI). AA patients demonstrated reduced height posttransplant as reflected in a negative mean standard deviation score. The observed reduction was statistically significant only at 3 years following transplant. In contrast, leukemia patients showed a significant loss in relative height that was first visible at 1 year post-BMT and continued until at least 4 years post-BMT. Mean growth velocities in the leukemia patients were significantly below median for the 3 years following transplant. With a median follow-up of 4 years, antithymocyte globulin plus steroids in combination with methotrexate as graft vs. host prophylaxis was associated with less severe growth suppression than methotrexate alone, while there were no significant associations between growth during the first 2 years following transplant and prepubertal status at transplant (as defined by age), graft vs. host disease, thyroid or gonadal function, or previous therapies received by the leukemia patients. Children undergoing marrow transplantation, particularly those receiving TBI, are at significant risk of subsequent growth suppression.

• Research Organization: Univ. of Minnesota, Minneapolis (USA)
• OSTI ID: 5815756
• Journal Information: Am. J. Pediatr. Hematol./Oncol.; (United States), Journal Name: Am. J. Pediatr. Hematol./Oncol.; (United States) Vol. 11:2; ISSN APHOD
• Country of Publication: United States
• Language: English

Related Subjects

560151* -- Radiation Effects on Animals-- Man
63 RADIATION, THERMAL, AND OTHER ENVIRON. POLLUTANT EFFECTS ON LIVING ORGS. AND BIOL. MAT.
AGE GROUPS
ANEMIAS
ANIMAL GROWTH
ANIMAL TISSUES
BIOLOGICAL EFFECTS
BIOLOGICAL RADIATION EFFECTS
BODY
BONE MARROW
CHILDREN
DIMENSIONS
DISEASES
EXTERNAL IRRADIATION
GRAFT-HOST REACTION
GROWTH
HEIGHT
HEMATOPOIETIC SYSTEM
HEMIC DISEASES
IRRADIATION
ORGANS
RADIATION EFFECTS
SYMPTOMS
TISSUES
TRANSPLANTS
WHOLE-BODY IRRADIATION