Oğuz Aynur, Pinarli F Güçlü, Karadeniz Ceyda, Bideci Aysun, Ozkan Seçil
Department of Pediatric Oncology, Gazi University Medical Faculty, Ankara, Turkey.
Leuk Lymphoma. 2006 Jul;47(7):1283-9. doi: 10.1080/10428190500467776.
Growth impairment is one of the most important late sequelae in childhood malignancies. In the last few years, the contribution of cytotoxic agents to growth retardation has been a subject of investigation. The aim of this study was to evaluate the growth impairment in children treated for non-Hodgkin's lymphoma (NHL). The study group comprised 41 children (eight girls, 33 boys) treated for NHL with three different chemotherapy protocols. All patients were in remission at the last visit. The control group consisted of 41 healthy age- and sex-matched children. All patients' standing heights and body weights were measured regularly from the time of diagnosis. Growth parameters were measured both at the time of diagnosis and at the end of treatment (median treatment time: 6 months). Height and weight velocities were calculated at 6 month intervals after the diagnosis until the last visit. The mean height SDS of the patients was -0.66 +/- 1.42 at the diagnosis and 0.29 +/- 1.21 at the last visit. Height SDS of the patients showed a significant improvement at the end of the 2nd year after the diagnosis (p = 0.005) and at the last visit (p = 0.022) (median follow-up time: 48 months after diagnosis). The height velocity SDS increase at the end of the 2nd year was particularly remarkable in short-term protocols such as BFM-90 B-NHL. The sitting height, the sitting height/height ratio and serum insulin-like growth factor-I (IGF-I) levels were found to be lower in the patients than those of control group at the last visit. One can conclude that chemotherapy might cause a reduction in growth velocity during treatment. The cumulative dosages of anti-neoplastic agents and serum IGF-I levels could have been implied in the pathogenesis of growth retardation.
生长发育受损是儿童恶性肿瘤最重要的晚期后遗症之一。在过去几年中，细胞毒性药物对生长发育迟缓的影响一直是研究的课题。本研究的目的是评估接受非霍奇金淋巴瘤（NHL）治疗的儿童的生长发育受损情况。研究组包括41名接受三种不同化疗方案治疗的NHL儿童（8名女孩，33名男孩）。所有患者在最后一次随访时均处于缓解期。对照组由41名年龄和性别匹配的健康儿童组成。从诊断时起定期测量所有患者的身高和体重。在诊断时和治疗结束时（中位治疗时间：6个月）测量生长参数。在诊断后至最后一次随访期间，每隔6个月计算一次身高和体重增长速度。患者的平均身高标准差在诊断时为-0.66±1.42，在最后一次随访时为0.29±1.21。患者的身高标准差在诊断后第2年末（p = 0.005）和最后一次随访时（p = 0.022）有显著改善（中位随访时间：诊断后48个月）。在BFM-90 B-NHL等短期方案中，第2年末身高增长速度标准差的增加尤为显著。在最后一次随访时，发现患者的坐高、坐高/身高比和血清胰岛素样生长因子-I（IGF-I）水平低于对照组。可以得出结论，化疗可能会导致治疗期间生长速度下降。抗肿瘤药物的累积剂量和血清IGF-I水平可能与生长发育迟缓的发病机制有关。
