Growth in patients after allogeneic bone marrow transplant for hematological diseases in childhood.
The growth of 66 long-term survivors, transplanted in two centres (Genoa S. Martino and Monza) is reported. Patients were all under age 15 at the time of bone marrow transplantation (mean 9.8 +/- 3.4 years; range 1.07-15 years) with a minimum follow-up of at least 12 months. They were divided into four groups. Group 1: eight patients with severe aplastic anemia (SAA): conditioning included cyclophosphamide (CY) 200 mg/kg only. Group 2: 32 patients with acute lymphoblastic leukemia (ALL), and acute myeloid leukemia (AML): conditioning included CY 120 mg/kg and 10-12 Gy fractionated total body irradiation (fTBI). Group 3: 20 patients with ALL, who had previously received cranial irradiation; conditioning included CY 120 mg/kg and fTBI with an additional testicular irradiation (4 Gy). Group 4: six patients with chronic myeloid leukemia (CML) and AML; conditioning included CY 200 mg/kg and busulfan (BU) 16 mg/kg. Group was impaired in all four groups, including the unirradiated groups (-0.2 +/- 0.7 and -0.5 +/- 0.6 delta-SDS in groups I and 4, respectively). Growth impairment-SDS was statistically significant in the two irradiated groups (-0.7 +/- 1.0 and -0.9 +/- 1.0 delta-SDS in groups 2 and 3, respectively), more marked in patients who had had previous cranial irradiation. Chronic graft-versus-host disease and its treatment were not found to have a major effect on growth.
Cohen
A
A
University Department of Pediatrics, G. Gaslini Institute Children's Hospital, Genoa, Italy.
van Lint
M T
MT
Uderzo
C
C
Rovelli
A
A
Lavagetto
A
A
Vitale
V
V
Morchio
A
A
Locasciulli
A
A
Bacigalupo
A
A
Romano
C
C
D000208:Acute Disease; D000293:Adolescent; D000741:Anemia, Aplastic / Q000503:physiopathology / Q000628:therapy; D016026:Bone Marrow Transplantation; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006086:Graft vs Host Disease / Q000150:complications* / Q000503:physiopathology / Q000628:therapy; D006128:Growth / Q000502:physiology; D006402:Hematologic Diseases / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D007223:Infant; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000503:physiopathology / Q000628:therapy; D007951:Leukemia, Myeloid / Q000503:physiopathology / Q000628:therapy; D008297:Male; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000503:physiopathology / Q000628:therapy; D017741:Survivors; D013789:Thalassemia / Q000503:physiopathology / Q000628:therapy; D014184:Transplantation, Homologous; D014916:Whole-Body Irradiation