Changes in height, weight and plasma leptin after bone marrow transplantation.
Short stature can be a severe side-effect of bone marrow transplantation (BMT). Because of the effect of weight changes on growth rate and on plasma insulin-like growth factor (IGF I), we analyzed changes in height and body mass index (BMI) in 53 patients given BMT. Group 1 (n = 22) was given 12 Gy total body irradiation (TBI) as six fractions, group 2 (n = 14) 10 Gy TBI (one dose), group 3 (n = 8) 6 Gy total lymphoid irradiation (one dose), and group 4 (n = 9) chemotherapy alone. At the first evaluation, 13/36 patients in groups 1 and 2 had low growth hormone (GH) peaks after stimulation. The mean plasma IGF I concentrations (z score) were similar in groups 1 (-2.9 +/- 0.3) and 2 (-2.5 +/- 0.3), and in groups 3 (-1.4 +/- 0.3) and 4 (-1.4 +/- 0.7), but those of group 1 were lower than those of groups 3 (P < 0.01) and 4 (P < 0.05), and those of group 2 than those of group 3 (P < 0.05). BMI during the 5 years after BMT did not change in groups 1 and 2, decreased in group 3, and increased in group 4. However, these changes were not significant. Most of the patients given TBI had BMI below the mean at 2 (66%) and 5 (57%) years later. Their BMI and leptin concentrations correlated positively with each other (P = 0.005), and negatively with GH peak (P = 0.02 for BMI and 0.007 for leptin). In conclusion, this study suggests that TBI actually decreases GH secretion and is followed by a persistent low BMI. The negative relationship between GH peak and leptin may indicate that both are markers of a TBI-induced hypothalamic-pituitary lesion.
Couto-Silva
A C
AC
Pediatric Endocrinology Department, Université René Descartes and H pital Necker-Enfants Malades, Paris, France.
Trivin
C
C
Esperou
H
H
Michon
J
J
Fischer
A
A
Brauner
R
R
D000293:Adolescent; D000328:Adult; D001827:Body Height; D015992:Body Mass Index; D001835:Body Weight; D016026:Bone Marrow Transplantation / Q000009:adverse effects* / Q000379:methods; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006130:Growth Disorders / Q000097:blood / Q000209:etiology; D019382:Human Growth Hormone / Q000097:blood / Q000378:metabolism; D006801:Humans; D007223:Infant; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D020738:Leptin / Q000097:blood*; D008297:Male; D008875:Middle Aged; D019172:Transplantation Conditioning / Q000009:adverse effects / Q000379:methods; D015431:Weight Loss; D014916:Whole-Body Irradiation / Q000009:adverse effects
D020738:Leptin; D019382:Human Growth Hormone; D007334:Insulin-Like Growth Factor I