Height and weight in children treated for acute lymphoblastic leukemia: relationship to CNS treatment.
OBJECTIVE
We evaluated the long-term effects of treatment on height and weight in children with acute lymphoblastic leukemia (ALL) treated with one of the following three different CNS therapies: intrathecal therapy alone, intrathecal therapy with conventional cranial radiation, or intrathecal therapy with twice-daily radiation.


METHODS
Between 1987 and 1995, 618 children treated on two consecutive Dana-Farber Cancer Institute Consortium protocols for ALL were measured for height and weight at diagnosis, and approximately every 6 months thereafter. Patient height, weight, and body mass index (BMI) were converted to z scores for age and sex using the 2000 Centers for Disease Control and Prevention growth charts for the United States.


RESULTS
Children younger than 13 years at diagnosis had a statistically significant decrease in their height z scores and an increase in their BMI z scores, regardless of whether they had received cranial radiation. Young age at diagnosis and increased chemotherapy intensity were major risk factors. Unexpectedly, there was no significant difference in long-term height between children who received radiation and those who did not.


CONCLUSIONS
Final height is compromised in survivors of ALL. The detrimental effects on height occur during therapy without the ability for long-term catch-up growth. Although patients became overweight for height, this seemed to be a result of relative height loss with normal weight gain rather than accelerated weight gain. The type of CNS treatment received did not affect changes in height, weight, or BMI.
Dalton
Virginia Kimball
VK
Department of Medicine, Children's Hospital, Boston, MA 02115, USA. Virginia_Dalton@dfci.harvard.edu.
Rue
Montse
M
Silverman
Lewis B
LB
Gelber
Richard D
RD
Asselin
Barbara L
BL
Barr
Ronald D
RD
Clavell
Luis A
LA
Hurwitz
Craig A
CA
Moghrabi
Albert
A
Samson
Yvan
Y
Schorin
Marshall
M
Tarbell
Nancy J
NJ
Sallan
Stephen E
SE
Cohen
Laurie E
LE
D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001827:Body Height; D015992:Body Mass Index; D001835:Body Weight; D002648:Child; D002675:Child, Preschool; D016371:Cranial Irradiation / Q000009:adverse effects; D004307:Dose-Response Relationship, Radiation; D005260:Female; D006801:Humans; D007223:Infant; D016014:Linear Models; D008297:Male; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000503:physiopathology / Q000628:therapy*; D012307:Risk Factors