Final adult height of patients who received hematopoietic cell transplantation in childhood

Growth impairment and growth hormone (GH) deficiency are complications after total body irradiation (TBI) and hematopoietic cell transplantation (HCT). To determine the impact of GH therapy on growth, the final heights of 90 GH-deficient children who underwent fractionated TBI and HCT for malignancy...

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Veröffentlicht in:Blood 2005-02, Vol.105 (3), p.1348-1354
Hauptverfasser: Sanders, Jean E., Guthrie, Katherine A., Hoffmeister, Paul A., Woolfrey, Ann E., Carpenter, Paul A., Appelbaum, Frederick R.
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container_end_page 1354
container_issue 3
container_start_page 1348
container_title Blood
container_volume 105
creator Sanders, Jean E.
Guthrie, Katherine A.
Hoffmeister, Paul A.
Woolfrey, Ann E.
Carpenter, Paul A.
Appelbaum, Frederick R.
description Growth impairment and growth hormone (GH) deficiency are complications after total body irradiation (TBI) and hematopoietic cell transplantation (HCT). To determine the impact of GH therapy on growth, the final heights of 90 GH-deficient children who underwent fractionated TBI and HCT for malignancy were evaluated. Changes in height standard deviation (SD) from the diagnosis of GH deficiency to the achievement of final height were compared among 42 who did and 48 who did not receive GH therapy. At HCT, GH-treated patients were younger (P = .001), more likely to have undergone central nervous system irradiation (P = .007), and shorter (P = .005) than patients who did not receive GH therapy. After HCT, GH deficiency was diagnosed at 1.5 years (range, 0.8-9.5 years) for GH-treated and 1.2 years (range, 0.9-8.8 years) for nontreated patients. GH therapy was associated with significantly improved final height in children younger than 10 years at HCT (P = .0001), but GH therapy did not impact the growth of older children. Girls (P = .0001) and children diagnosed with acute myelogenous leukemia (AML), chronic myelogenous leukemia (CML), or myelodysplastic syndromes (MDS) (compared with acute lymphoblastic leukemia [ALL] or non-Hodgkin lymphoma [NHL]; P = .02) also showed more rapid growth than their counterparts. These data demonstrate that GH therapy improves the final height of young children after fractionated TBI.
doi_str_mv 10.1182/blood-2004-07-2528
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To determine the impact of GH therapy on growth, the final heights of 90 GH-deficient children who underwent fractionated TBI and HCT for malignancy were evaluated. Changes in height standard deviation (SD) from the diagnosis of GH deficiency to the achievement of final height were compared among 42 who did and 48 who did not receive GH therapy. At HCT, GH-treated patients were younger (P = .001), more likely to have undergone central nervous system irradiation (P = .007), and shorter (P = .005) than patients who did not receive GH therapy. After HCT, GH deficiency was diagnosed at 1.5 years (range, 0.8-9.5 years) for GH-treated and 1.2 years (range, 0.9-8.8 years) for nontreated patients. GH therapy was associated with significantly improved final height in children younger than 10 years at HCT (P = .0001), but GH therapy did not impact the growth of older children. Girls (P = .0001) and children diagnosed with acute myelogenous leukemia (AML), chronic myelogenous leukemia (CML), or myelodysplastic syndromes (MDS) (compared with acute lymphoblastic leukemia [ALL] or non-Hodgkin lymphoma [NHL]; P = .02) also showed more rapid growth than their counterparts. These data demonstrate that GH therapy improves the final height of young children after fractionated TBI.</description><identifier>ISSN: 0006-4971</identifier><identifier>EISSN: 1528-0020</identifier><identifier>DOI: 10.1182/blood-2004-07-2528</identifier><identifier>PMID: 15454481</identifier><language>eng</language><publisher>Washington, DC: Elsevier Inc</publisher><subject>Adolescent ; Adult ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Biological and medical sciences ; Body Height - drug effects ; Bone marrow, stem cells transplantation. Graft versus host reaction ; Child ; Child, Preschool ; Female ; Growth - drug effects ; Growth - physiology ; Hematologic Neoplasms - therapy ; Human Growth Hormone - blood ; Human Growth Hormone - deficiency ; Human Growth Hormone - therapeutic use ; Humans ; Infant ; Male ; Medical sciences ; Middle Aged ; Stem Cell Transplantation ; Transfusions. Complications. Transfusion reactions. 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Girls (P = .0001) and children diagnosed with acute myelogenous leukemia (AML), chronic myelogenous leukemia (CML), or myelodysplastic syndromes (MDS) (compared with acute lymphoblastic leukemia [ALL] or non-Hodgkin lymphoma [NHL]; P = .02) also showed more rapid growth than their counterparts. These data demonstrate that GH therapy improves the final height of young children after fractionated TBI.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Biological and medical sciences</subject><subject>Body Height - drug effects</subject><subject>Bone marrow, stem cells transplantation. 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subjects Adolescent
Adult
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Biological and medical sciences
Body Height - drug effects
Bone marrow, stem cells transplantation. Graft versus host reaction
Child
Child, Preschool
Female
Growth - drug effects
Growth - physiology
Hematologic Neoplasms - therapy
Human Growth Hormone - blood
Human Growth Hormone - deficiency
Human Growth Hormone - therapeutic use
Humans
Infant
Male
Medical sciences
Middle Aged
Stem Cell Transplantation
Transfusions. Complications. Transfusion reactions. Cell and gene therapy
Whole-Body Irradiation
title Final adult height of patients who received hematopoietic cell transplantation in childhood
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