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Growth and pubertal patterns in young survivors of childhood acute lymphoblastic leukemia

  • Sarah Elitzur , Revital Houri-Shtrecher , Michal Yackobovitz-Gavan , Galia Avrahami , Shlomit Barzilai , Gil Gilad , Yael Lebenthal , Moshe Phillip , Batia Stark , Isaac Yaniv und Shlomit Shalitin EMAIL logo
Veröffentlicht/Copyright: 25. Juli 2017
Journal of Pediatric Endocrinology and Metabolism
Aus der Zeitschrift Journal of Pediatric Endocrinology and Metabolism Band 30 Heft 8

Abstract

Background:

Survivors of acute lymphoblastic leukemia (ALL) may experience endocrine dysfunction. This study evaluated growth and pubertal patterns in survivors of childhood ALL.

Methods:

Longitudinal assessment of anthropometric measurements and pubertal status was performed in a retrospective cohort of survivors (n=183). Median age at last endocrine visit was 16.1 years (range 8.2–27.6); median follow-up time was 8.7 years (range 3–21.4).

Results:

Treatment with chemotherapy+prophylactic cranial radiation (pCRT, n=29) was associated with lower mean height standard deviation score (SDS) than chemotherapy alone (n=154) (p=0.001) and higher prevalence of adult short stature (13% vs. 2.2%). Mean age at pubertal onset was normal (girls: 10.3±1.3 years; boys: 12.0±1.3 years). Precocious puberty, diagnosed in 8.7% of patients, was more prevalent in pCRT-treated girls. Rates of overweight and obesity were 22.9% and 9.3%, respectively. Predictors of endocrine disorders were pCRT (p=0.031) and female gender (p=0.041); of obesity, higher body mass index (BMI)-SDS at diagnosis (p=0.001); and of short stature, lower height-SDS at diagnosis (p=0.038).

Conclusions:

Most childhood ALL survivors given chemotherapy alone attain normal adult height and puberty. Childhood ALL survivors are at increased risk of overweight, especially those with increased BMI at diagnosis. Clinicians should screen for overweight early in survivorship and introduce early interventions.

Keywords: acute lymphoblastic leukemia; growth; obesity; puberty; survivors
Corresponding author: Professor Shlomit Shalitin, MD, The Jesse Z. and Lea Shafer Institute for Endocrinology and Diabetes, National Center for Childhood Diabetes, Schneider Children’s Medical Center of Israel, 14 Kaplan Street, Petach Tikva 4920235, Israel, Phone: +972-3-925-3282, Fax: +972-3-925-3836
Sarah Elitzur and Revital Huri-Shtrecher contributed equally to this work.

Acknowledgments

The authors wish to thank Gloria Ginzach for editorial assistance.

  1. Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

  2. Research funding: None declared.

  3. Employment or leadership: None declared.

  4. Honorarium: None declared.

  5. Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.

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Received: 2017-3-6
Accepted: 2017-6-26
Published Online: 2017-7-25
Published in Print: 2017-8-28

©2017 Walter de Gruyter GmbH, Berlin/Boston

Artikel in diesem Heft

  1. Frontmatter
  2. Editorial
  3. Endocrine aspects in cystic fibrosis
  4. Original Articles
  5. A retrospective analysis of longitudinal changes in bone mineral content in cystic fibrosis
  6. Cystic-fibrosis related-diabetes (CFRD) is preceded by and associated with growth failure and deteriorating lung function
  7. Partial clinical remission in type 1 diabetes: a comparison of the accuracy of total daily dose of insulin of <0.3 units/kg/day to the gold standard insulin-dose adjusted hemoglobin A1c of ≤9 for the detection of partial clinical remission
  8. Concentrations of leptin, adiponectin and other metabolic parameters in non-obese children with Down syndrome
  9. Parent reported nutritional risk and laboratory indices of cardiometabolic risk and in preschool-aged children
  10. Multinodular goiter in children: treatment controversies
  11. Atopy as a risk factor for subclinical hypothyroidism development in children
  12. Mutation analysis of the NKX2.5 gene in Iranian pediatric patients with congenital hypothyroidism
  13. Health-related quality of life among children with Turner syndrome: controlled cross-sectional study
  14. Growth and pubertal patterns in young survivors of childhood acute lymphoblastic leukemia
  15. Clinical features and genotyping of patients with primary carnitine deficiency identified by newborn screening
  16. Letter to the Editor
  17. Sensitivity and specificity of cystic fibrosis-related diabetes screening methods: which test should be the reference method?
  18. Case Reports
  19. Type 1 rhizomelic chondrodysplasia punctata with a homozygous PEX7 mutation
  20. Severe hypertriglyceridemia at new onset type 1 diabetes mellitus
  21. 45,X/46,XY ovotesticular disorder of sex development revisited: undifferentiated gonadal tissue may be mistaken as ovarian tissue
  22. MRI in medium-chain acyl-coenzyme a dehydrogenase deficiency: neuroimaging during the first month
https://doi.org/10.1515/jpem-2017-0099
Schlagwörter für diesen Artikel
acute lymphoblastic leukemia; growth; obesity; puberty; survivors

Artikel in diesem Heft

  1. Frontmatter
  2. Editorial
  3. Endocrine aspects in cystic fibrosis
  4. Original Articles
  5. A retrospective analysis of longitudinal changes in bone mineral content in cystic fibrosis
  6. Cystic-fibrosis related-diabetes (CFRD) is preceded by and associated with growth failure and deteriorating lung function
  7. Partial clinical remission in type 1 diabetes: a comparison of the accuracy of total daily dose of insulin of <0.3 units/kg/day to the gold standard insulin-dose adjusted hemoglobin A1c of ≤9 for the detection of partial clinical remission
  8. Concentrations of leptin, adiponectin and other metabolic parameters in non-obese children with Down syndrome
  9. Parent reported nutritional risk and laboratory indices of cardiometabolic risk and in preschool-aged children
  10. Multinodular goiter in children: treatment controversies
  11. Atopy as a risk factor for subclinical hypothyroidism development in children
  12. Mutation analysis of the NKX2.5 gene in Iranian pediatric patients with congenital hypothyroidism
  13. Health-related quality of life among children with Turner syndrome: controlled cross-sectional study
  14. Growth and pubertal patterns in young survivors of childhood acute lymphoblastic leukemia
  15. Clinical features and genotyping of patients with primary carnitine deficiency identified by newborn screening
  16. Letter to the Editor
  17. Sensitivity and specificity of cystic fibrosis-related diabetes screening methods: which test should be the reference method?
  18. Case Reports
  19. Type 1 rhizomelic chondrodysplasia punctata with a homozygous PEX7 mutation
  20. Severe hypertriglyceridemia at new onset type 1 diabetes mellitus
  21. 45,X/46,XY ovotesticular disorder of sex development revisited: undifferentiated gonadal tissue may be mistaken as ovarian tissue
  22. MRI in medium-chain acyl-coenzyme a dehydrogenase deficiency: neuroimaging during the first month
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