Reactions 511 - 23 Jul 1994

Antineoplastics/radiotherapy

Short stature in children with leukaemia: incidencestudy

A significant loss of standing height, possibly associatedwith a relatively short spine were observed in a group ofchildren who had received combination antineoplastic therapywith cranial irradiation for acute lymphoblastic leukaemia.

The retrospective UK study examined a cohort of 142children aged 1.4–13.9 years who received inductiontreatment with asparaginase, vincristine and prednisolone,followed by maintenance therapy with methotrexate,mercaptopurine, prednisolone and vincristine. 48 girls and 36boys received 24 Gy cranial irradiation and 35 girls and 23boys received 18 Gy cranial irradiation.

All patients had a significant reduction in their standingheight SD score at diagnosis and height SD score at finalheight. Change in height SD score correlated with younger ageat diagnosis and taller stature at diagnosis in all groups exceptthe boys who received 24 Gy irradiation.

81% of children evaluated for sitting heights (n = 109) hadrelatively shorter backs than legs; this was significant in 25(23%) children. Of the latter patients, an equal number hadreceived 24 and 18 Gy cranial irradiation. When a correctedallowance was made for a short spine, significant heightreductions were apparent only in the group of girls receiving24 Gy irradiation.

Author comment: ‘At least in some children, much if not allof the height loss seen after treatment for ALL [acutelymphoblastic leukaemia] is due to loss of sitting height.’Possible explanations for this disproportion include adisturbance in pubertal growth and/or a direct effect ofantineoplastic therapy on the cartilage growth plate.Davies HA, et al. Disproportionate short stature after cranial irradiation andcombination chemotherapy for leukaemia. Archives of Disease in Childhood 70:472-475, Jun 1994 - England 800282273

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Reactions 23 Jul 1994 No. 5110114-9954/10/0511-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved