Arch Dis Child 1998;79:161-164 ( August )

Height and weight pattern up to 20 years after treatment for acute lymphoblastic leukaemia

N H Birkebæk, N Clausen

Department of Pediatrics, University Hospital of Aarhus at Skejby, 8200 Aarhus N, Denmark

Correspondence to: Dr N H Birkebæk, Skovgårdsparken 44, 7080 Børkop, Denmark.

Accepted 11 March 1998

OBJECTIVETo assess height and body mass index standard deviation scores up to 20 years after treatment for acute lymphoblastic leukaemia (ALL).
SUBJECTS AND METHODSHeight and body mass index standard deviation scores were measured in 33 patients (14 boys and 19 girls) with childhood ALL at diagnosis, after the end of treatment, at final height, and at follow up 10-20 years (median, 16.2) after diagnosis. Eleven patients were treated with chemotherapy only and 22 patients were treated with chemotherapy and cranial irradiation.
RESULTSIn the chemotherapy only group, height standard deviation scores were the same at follow up as at diagnosis, but there was a significant decrease in height standard deviation scores during treatment. Mean body mass index standard deviation scores increased steadily from the start of treatment until final height and continued to increase from final height until follow up. In the cranially irradiated group, mean height standard deviation scores decreased steadily from the start of treatment until follow up. Mean body mass index standard deviation scores increased continuously from the start of treatment until final height and from final height until follow up.
CONCLUSIONChemotherapy combined with cranial irradiation and chemotherapy alone might be persisting risk factors for obesity even after final height has been attained in patients treated for childhood ALL. Chemotherapy is a risk factor for reduced final height only when administered in combination with cranial irradiation. These problems need to be recognised and dealt with at follow up examination.

Key messages Chemotherapy and chemotherapy combined with cranial irradiation increase mean body mass index standard deviation scores from diagnosis to final height in patients treated for childhood acute lymphoblastic leukaemia For both treatments, a further increase in body mass index standard deviation scores occurs after final height has been attained Chemotherapy and chemotherapy combined with cranial irradiation reduce height standard deviation scores during treatment Chemotherapy alone does not reduce final height in patients treated for childhood acute lymphoblastic leukaemia

Keywords: acute lymphoblastic leukaemia; body mass index standard deviation score; height standard deviation score; chemotherapy; radiotherapy

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© 1998 by Archives of Disease in Childhood
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