52 GROWTH AND PUBERTY IN SURVIVORS OF CHILDHOOD LEUKAEMIA

Abstract

Childhood leukaemia is often associated with impaired growth and disorders of puberty. To see how common this is we re-examined all 13 survivors (9f, Am) of acute lymphoblastic leukaemia treated during childhood in our hospital 1964-1981. At diagnosis, aged 0.8 to 13.7 years, their mean height SDS was +0.9. They were given various chemotherapy, glucocorticoids and 11 had cranial irradiation (1600-2600 rad). During the first year after diagnosis the mean height velocity SDS was -1.4 (SD 1.2), and 6 of 13 lost >0.5 of their height SDS. By the end of therapy (7 years in 2, 3 to 3.6 years in 11) the mean height SDS was was +0.3 (SD 1.3) and 7 had lost >0.5 of their height SDS. After cancer therapy (follow-up 3 to 13 years) an improvement of height SDS >0.5 SD was seen in 4 and a deterioration in 1, due to scoliosis after paraplegia as a treatment complication. Of those 7 who had reached their final height, 4 were >1SD shorter than their midparert height SDS, 1 was 1 SD taller. Of those 6 still growing (aged 7.6 to 12.5 years) 3 were >1SD taller than their midparent height SDS and none was short. Five were obese with a relative weight for height of >120%, 2 were lean <90%. None of the girls had abnormal timing of puberty, and 2 had children. One boy was early in his puberty (G2 at 9.0 years). In conclusion, childhood leukaemia had impaired the growth of some of our patients, but their height deficit was not severe. Abnormal puberty was seen in only one of 13.