Impact of treatment on the growth of children treated for acute
lymphoblastic leukemia
Abstract
Background: Endocrine disturbances are frequent long-term complications
of acute lymphoblastic leukemia (ALL) treatment. Research on the risk of
impaired linear growth and overweight has reported conflicting results.
Procedure: A longitudinal, retrospective study for the characterization
of growth (height and body mass index (BMI)) was performed, based on the
clinical records of patients treated for ALL since 2003 and off
treatment for a minimum of two years. Data on height and weight were
collected at diagnosis (0M) and at 6, 12, 24 and 48 months (M), as well
as the most recent height (FH). Effects of cranial radiotherapy (CRT)
and sex on growth changes were evaluated. FH was compared with target
height (TH). Results: 78 patients (52.5% males) met the inclusion
criteria. CRT was used in 28.2%. Height percentile (HP) was reduced at
6M reaching a minimum at 12M; this recovered at 48M, but was still
inferior to diagnosis for females and most significantly in the CRT
group. Diagnosis HP was in general higher than TH. Overweight/obesity
affected 21.8% patients at 0M, 45.9% at 12M and 71.4% at 24M. BMI
percentile (BP) decreased from 24M to 48M but was still higher than at
0M. The CRT-group had no significant decrease in BP from 24M to 48M.
Conclusions: ALL treatment affected linear growth and caused an increase
in BMI, with a higher impact on CRT-treated patients for both studied
parameters and in females only for height. FH appeared not to be
inferior to patient’s genetic potential. BMI remained increased after
treatment.