Growth and endocrinological disorders up to 21 years after treatment for acute lymphoblastic leukemia in childhood
✍ Scribed by Birkebæk, N. H.; Fisker, S.; Clausen, N.; Tuovinen, V.; Sindet-Pedersen, S.; Christiansen, J. S.
- Publisher
- John Wiley and Sons
- Year
- 1998
- Tongue
- English
- Weight
- 81 KB
- Volume
- 30
- Category
- Article
- ISSN
- 0098-1532
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✦ Synopsis
Background:
Our aim was to evaluate endocrinological status 10-21 years after treatment for childhood acute lymphoblastic leukemia (all) with chemotherapy (c) and cranial irradiation (c + i) or only c, and to correlate the endocrine data with growth parameters.
Procedure:
Of 30 patients (15 females and 15 males), 18 were treated with c + i and 12 were treated with c only. height standard deviation score (hsds) and body mass index standard deviation score (bmisds) before treatment, at end of treatment, and at follow-up were calculated from height and weight registered from the charts. at follow-up examinations, provocative growth hormone (gh) tests (clonidine and insulin tolerance test) and an acth test were performed. furthermore, blood samples for hormonal analysis, igf-i, igfbp-3, ghbp, and leptin were drawn.
Results:
Eleven patients (9 treated with c + i and 2 treated with c) showed insufficient response to gh tests. two patients had hypogonadism. hsds and igf-i were significantly lower and ghbp significantly higher in gh-deficient patients compared to the group with normal gh secretion at follow-up. bmisds steadily increased from start of treatment until follow-up, independent of gh status at follow-up. bmisds at follow-up was positively correlated with serum leptin (p < 0.001), and serum leptin was significantly higher in the cranial irradiated group as compared to the nonirradiated group.
Conclusions:
Gh deficiency is frequently found at long-term follow-up in patients treated for childhood all. other hormonal deficiencies are rare. hsds at long-term follow-up is dependent on gh secretory status. long-term endocrinological follow-up examinations in patients treated for childhood all are recommended, as hormonal replacement therapy may be indicated.