[Analysis of some risk factors for abnormal growth velocity in children treated with haematopoetic stem cell transplantation].
BACKGROUND
Late effects following haematopoietic stem cell transplantation occur both in children and adults. Endocrine impairment may cause abnormal growth velocity and impaired growth in children.


OBJECTIVE
To assess the influence of preparative regimen-high dose chemotherapy and/or cranial irradiation as risk factors for growth impairment.


METHODS
30 children underwent haematopoetic stem cell transplantation (19 girls, 11 boys) aged 2-20 years, with autologous (N=9) or allogeneic (N=21) maneuver. 14 children received cranial irradiation prior to grafting: 18 Gy (N=10) and 24 Gy (N-4), high doses chemotherapy included Busulfan/Melphalan (N=6), Cyclophosphamide/Busulfan/ Etoposide (N=6) and total body irradiation with 12 Gy (N=2). Thyroid function was evaluated prior to and after grafting. Growth hormone secretion with standard provocative test were analyzed. Bone age was estimated. State of nutrition 12 to 5 months before and after transplantation, WLI (weight-for-length index) and BMI (body mass index) were evaluated. Abnormal growth velocity denotes decrease > or =1 SD.


RESULTS
1. Cyclophosphamide statistically significantly blunted growth velocity 4 (n=28; p=0.046; r=0.4). 2. Significant correlation (n=28; p=0.0184; r=0.45) was found between abnormal gonadal function and Busulfan. 3. Cranial irradiation prior to preparative regimen impaired growth more significantly than high dose chemotherapy (n=28; p=0.0044). 4. Evaluated WLI determined short stature after transplantation (n=26; p<0.001).


CONCLUSIONS
Hematopoietic stem cell transplantation causes long term endocrine complications especially impaired growth.
Wójcik
Dorota
D
Klinika Transplantacji Szpiku, Onkologii i Hematologii Dzieciecej, ul. Bujwida 44, 50-345 Wrocław, Poland.
Barg
Ewa
E
Niedzielska
Ewa
E
Doroszko
Adrian
A
Kałwak
Krzysztof
K
Pietras
Wojciech
W
D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D001827:Body Height / Q000187:drug effects / Q000528:radiation effects; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy / Q000009:adverse effects; D016371:Cranial Irradiation / Q000009:adverse effects*; D004700:Endocrine System Diseases / Q000209:etiology; D005260:Female; D006130:Growth Disorders / Q000209:etiology*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D008297:Male; D011044:Poland; D011832:Radiation Injuries / Q000209:etiology; D014916:Whole-Body Irradiation / Q000009:adverse effects