Late Effects in Children Treated for Acute Lymphoblastic Leukemia

Height and Weight Pattern after Cessation of Chemotherapy

Abstract

The growth of childhood acute lymphoblastic leukemia (ALL) was studied in 215 patients (140 boys and 75 girls) who had remained in remission for more than a year after the completion of their maintenance therapy. The median age at diagnosis was 4.2 years, and the median duration of follow-up from the time of diagnosis was 6.0 years. The children had been treated by ALL-protocol of the Children's Cancer and Leukemia Study Group. Heights and weights were examined at diagnoses up to 10 years after the cessation of chemotherapy. The Z score, which reflects the deviation of height and weight measurements from the population mean, was used to assess height and weight changes. The mean height Z score was-0.36 SD at the cessation of chemotherapy and-0.59 SD at 5 years. Seven years after the cessation of chemotherapy, the girls showed a decrease in the mean height Z score (-1.32 SD) compared with the boys (0.16 SD) (p<0.01). The mean weight Z score was 0.36 SD at the cessation of chemotherapy and-0.36 SD at 5 years. Obesity was seen in 7.9% at the cessation of chemotherapy. No obvious correlation between the administered cranial irradiation and growth failure was found. The short stature seen in patients treated for ALL is more pronounced in girls than in boys.