Growth after hematopoietic stem cell transplantation in children with acute myeloid leukemia

J Korean Med Sci. 2013 Jan;28(1):106-13. doi: 10.3346/jkms.2013.28.1.106. Epub 2013 Jan 8.

Abstract

Previous studies have shown that hematopoietic stem cell transplantation (HSCT) may result in growth impairment. The purpose of this study was to evaluate the growth during 5 yr after HSCT and to determine factors that influence final adult height (FAH). We retrospectively reviewed the medical records of acute myeloid leukemia (AML) patients who received HSCT. Among a total of 37 eligible patients, we selected 24 patients who began puberty at 5 yr after HSCT (Group 1) and 19 patients who reached FAH without relapse (Group 2). In Group 1, with younger age at HSCT, sex, steroid treatment, hypogonadism and hypothyroidism were not significantly associated with growth impairment 5 yr after HSCT. History of radiotherapy (RT) significantly impaired the 5 yr growth after HSCT. Chronic graft-versus-host disease (cGVHD) only temporarily impaired growth after HSCT. In Group 2, with younger age at HSCT, steroid treatment and hypogonadism did not significantly reduce FAH. History of RT significantly reduced FAH. Growth impairment after HSCT may occur in AML patients, but in patients without a history of RT, growth impairment seemed to be temporary and was mitigated by catch-up growth.

Keywords: Acute Myeloid Leukemia; Growth; Hematopoietic Stem Cell Transplantation; Radiotherapy; Total Body Irradiation.

MeSH terms

  • Adolescent
  • Body Height / radiation effects*
  • Child
  • Child, Preschool
  • Female
  • Graft vs Host Disease / pathology
  • Graft vs Host Disease / prevention & control
  • Hematopoietic Stem Cell Transplantation*
  • Humans
  • Hypogonadism / drug therapy
  • Hypogonadism / pathology
  • Infant
  • Leukemia, Myeloid, Acute / radiotherapy
  • Leukemia, Myeloid, Acute / therapy*
  • Male
  • Recurrence
  • Retrospective Studies
  • Risk Factors
  • Steroids / therapeutic use

Substances

  • Steroids