Jaruratanasirikul Somchit, Owasith Kesinee, Wongchanchailert Malai, Laosombat Vichai, Sriplung Hutcha
Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand.
J Pediatr Endocrinol Metab. 2004 May;17(5):719-26. doi: 10.1515/jpem.2004.17.5.719.
Growth patterns of 85 survivors of childhood leukemia were analyzed retrospectively. All patients remained in first remission with no central nervous system involvement. The mean age at diagnosis was 5.8 +/- 3.6 years. The diagnoses were acute lymphoblastic leukemia (ALL) in 68 patients (80%) and acute non-lymphoblastic leukemia (ANLL) in 17 patients (20%). All except two patients received cranial irradiation: 51 patients with 1,800 cGy and 32 patients with 2,400 cGy. Mean height SDS was -0.7 +/- 1.36 at the time of diagnosis, which decreased to -0.92 +/- 1.31 by the end of treatment, and further decreased to -1.14 +/- 1.38 at 6 years after cessation of treatment. Mean weight SDS was -0.55 +/- 1.13 at the time of diagnosis, increasing slightly to -0.39 +/- 1.02 at the end of treatment, and decreasing to -0.46 +/- 1.65 at 6 years after cessation of treatment. Of these survivors, 51 patients (26 boys and 25 girls) reached a final height that was 1.04 SDS or 5.3 cm less than their target height. There was no difference of height and weight SDS between patients with ALL and ANLL. Girls and boys had different growth patterns. Girls had a slightly increased height SDS and gained more weight after cessation of treatment, resulting in less final height deficit and overweight for height, whereas boys had further height and weight reduction resulting in more deficit of final height.
对85例儿童白血病幸存者的生长模式进行了回顾性分析。所有患者均处于首次缓解期，无中枢神经系统受累。诊断时的平均年龄为5.8±3.6岁。其中68例（80%）诊断为急性淋巴细胞白血病（ALL），17例（20%）诊断为急性非淋巴细胞白血病（ANLL）。除两名患者外，所有患者均接受了颅脑照射：51例接受1800 cGy照射，32例接受2400 cGy照射。诊断时平均身高标准差（SDS）为-0.7±1.36，治疗结束时降至-0.92±1.31，治疗停止6年后进一步降至-1.14±1.38。诊断时平均体重SDS为-0.55±1.13，治疗结束时略有增加至-0.39±1.02，治疗停止6年后降至-0.46±1.65。在这些幸存者中，51例患者（26名男孩和25名女孩）的最终身高比其目标身高低1.04 SDS或5.3厘米。ALL和ANLL患者之间的身高和体重SDS没有差异。女孩和男孩有不同的生长模式。女孩的身高SDS略有增加，治疗停止后体重增加更多，导致最终身高不足和身高对应的超重情况较少，而男孩的身高和体重进一步下降，导致最终身高不足更多。
