Comparison of Growth Impairment in Pediatric Patients with ALL, NHL Treated with Chemotherapy alone and Chemoradiotherapy

Abstract

Introduction: Acute Lymphoblastic Leukemia (ALL) and Non Hodgkin’s Lymphoma(NHL) are the most common cancers in childhood and adolescence. Most children with ALL and NHL have long term survival (>80%). Endocrinopathy is a common complication in pediatric cancers following the treatment (20-50% prevalence), in addition, cytotoxic chemotherapy and radiotherapy can influence side effect on growth parameters. Material and Methods: We evaluated growth percentiles in 50 children with ALL(n=25),NHL(n=25) . Age of our patients was 3-17 years in remission period who received chemotherapy with (n=25) or without (n=25) head and neck radiation. Patients with in less than 5th percentile height referred to assess the growth hormone deficiency (GHD) by insulin stimulating test. Results: Six (12%) Patients had less than 5th percentile height. From these patients 5 children (83.0% ) had isolated GHD. Cortisol, ACTH, Prolactin , IGF-1and IGF-BP3 were at normal value children underwent head and neck radiotherapy in addition to chemotherapy. We didn’t find significant difference between 2 treatment group in exact–fisher test (P= 0.189 (. Two patients (4.0%) had over weight in assessing BMI ( Body Mass Index). Conclusion: We have some patients with short stature and GHD then it is important to pay more attention about growth in pediatric with malignancy. Key words: ALL, Growth Hormone Deficiency, NHL, Radiotherapy.