Màrky I, Mellander L, Lannering B, Albertsson-Wikland K
Department of Paediatrics, Göteborg University, Sweden.
Med Pediatr Oncol. 1991;19(4):258-64. doi: 10.1002/mpo.2950190409.
Diminished growth rate during treatment for acute lymphoblastic leukemia (ALL) is of the multifactorial etiology. Effects on GH secretion have been shown after discontinuation of treatment including prophylactic CNS irradiation. Seventeen children treated for ALL with three different CNS preventive schedules were followed longitudinally with repeated estimations of the spontaneous GH secretion during a 24-month period. No difference was found in GH secretion during this time between patients who had received no radiotherapy and those who had received 18 or 24 Gy as CNS prophylaxis. During dexamethasone treatment the GH secretion was completely suppressed, which can be a mediator for the diminished growth rate during the first 2 years of ALL treatment. We conclude that there is no clinical reason to perform GH analysis within the first 24 months of treatment for ALL.
急性淋巴细胞白血病（ALL）治疗期间生长速率降低病因是多方面的。已表明在治疗停止后包括预防性中枢神经系统照射对生长激素（GH）分泌有影响。对17例接受三种不同中枢神经系统预防方案治疗ALL的儿童进行纵向随访，在24个月期间反复评估自发性GH分泌。未接受放疗的患者与接受18或24 Gy中枢神经系统预防放疗的患者在此期间GH分泌无差异。在地塞米松治疗期间，GH分泌被完全抑制，这可能是ALL治疗头2年生长速率降低的一个介导因素。我们得出结论，在ALL治疗的头24个月内进行GH分析没有临床依据。
