title: Growth in Children Treated for Acute Lymphoblastic Leukemia: Single Institution Report from North India.
abstract: Survivors of childhood leukemia are at risk of impaired growth and short stature as adults due to intensive combination chemotherapy and radiation injury. This study was undertaken to evaluate anthropometry in children treated for acute lymphoblastic leukemia (ALL). Children treated for ALL and off treatment for a minimum period of 2 years were evaluated for height, weight and BMI. Z scores were calculated for height, weight and BMI: at induction, 6 months after starting treatment, at end of treatment and at 2 years after completion of therapy. Change in z scores were calculated and compared with CDC criteria and Agarwal standards for Indian children. Fifty two boys and 21 girls were analyzed. Height and weight z scores were seen to show a steep decrease during the initial intensive phase of therapy. The gain in height and weight continued to be slow during therapy and catch up occurred after cessation of therapy. On completion of therapy, patients were shorter, but not significantly so. Girls <9 years were significantly shorter. Weight remained on the lower side of normal. Change of z scores was statistically significant for weight at end of treatment (p = 0.032) and 2 years after completion of treatment (p = 0.00). BMI z score increased throughout the study period. Peak growth velocities were also late in the study subjects Anthropometric variables of height, weight and BMI are affected by ALL during therapy. Growth deceleration is maximum during the intensive phase of therapy. Catch up growth occurs but children remain smaller than their peers.
authors: Department of Pediatrics Advanced Pediatric Centre, Postgraduate Institute of Medical Education & Research, Chandigarh, 160012 India.
authors: Pankaj
authors: P
authors: Kumar
authors: Pediatric Hematology Oncology Unit, Postgraduate Institute of Medical Education & Research, Chandigarh, 160012 India.
authors: Amita
authors: A
authors: Trehan
authors: Department of Pediatrics Advanced Pediatric Centre, Postgraduate Institute of Medical Education & Research, Chandigarh, 160012 India.
authors: A K
authors: AK
authors: Bhalla
authors: Pediatric Hematology Oncology Unit, Postgraduate Institute of Medical Education & Research, Chandigarh, 160012 India.
authors: R K
authors: RK
authors: Marwaha
authors: Pediatric Hematology Oncology Unit, Postgraduate Institute of Medical Education & Research, Chandigarh, 160012 India.
authors: Deepak
authors: D
authors: Bansal
keywords: Acute lymphoblastic leukemia; BMI; Growth velocity; Height; Weight