Narumi Satoshi, Shimada Hiroyuki, Shimasaki Noriko, Takahashi Takao, Hasegawa Tomonobu, Mori Tetsuya
Department of Pediatrics, Keio University School of Medicine, Shinanomachi, Tokyo, Japan.
Pediatr Transplant. 2006 Feb;10(1):26-31. doi: 10.1111/j.1399-3046.2005.00388.x.
Growth failure is one of the most common late complications in children undergoing hematopoietic stem cell transplantation (SCT). The present report describes a qualitative method of evaluating height growth after SCT, using a growth chart. The patients were divided into three groups according to the shape of their growth chart: the normal growth chart group, the early-onset growth retardation group (E-group), in which a decreased growth rate was seen during the first year after SCT, and the late-onset growth retardation group (L-group), in which a decreased growth rate was seen more than 1 yr after the SCT. In the E-group, total body irradiation and prolonged steroid therapy were thought to contribute to the growth failure, whereas in the L-group, impaired pubertal development was thought to be responsible. The growth pattern in the L-group may, therefore, be of particular clinical importance, because the final stature of the subjects in this group can be improved by pharmacological adjustment of pubertal onset. Although limited by the small size and heterogeneous nature of the sample, our results suggest that growth-chart-based evaluation may provide important information to stratify subjects showing inadequate growth after SCT into two groups whose follow-up and treatment should be individualized.
生长发育迟缓是接受造血干细胞移植（SCT）儿童最常见的晚期并发症之一。本报告描述了一种使用生长图表评估SCT后身高增长的定性方法。根据生长图表的形状将患者分为三组：正常生长图表组、早发性生长迟缓组（E组），即在SCT后第一年生长速率下降，以及迟发性生长迟缓组（L组），即在SCT后1年以上生长速率下降。在E组中，全身照射和长期类固醇治疗被认为是导致生长发育迟缓的原因，而在L组中，青春期发育受损被认为是原因。因此，L组的生长模式可能具有特别的临床重要性，因为通过药物调整青春期开始时间可以改善该组受试者的最终身高。尽管样本量小且性质异质性有限，但我们的结果表明，基于生长图表的评估可能为将SCT后生长不足的受试者分为两组提供重要信息，其随访和治疗应个体化。
