Peking University People's Hospital, Department of Pediatrics, Beijing, 100044, China.
Peking University People's Hospital, Department of Pediatrics, Beijing, 100044, China.
Leuk Res. 2020 Aug;95:106405. doi: 10.1016/j.leukres.2020.106405. Epub 2020 Jun 15.
To investigate the effect of tyrosine kinase inhibitors (TKIs) on the statural growth in children with acute lymphoblastic leukemia (ALL).
We retrospectively collected data from 344 children with ALL younger than 17 years old at diagnosis identified in pediatric department of Peking University People's Hospital. The children were divided into three groups: conventional chemotherapy group, imatinib group and dasatinib group. Height was expressed as standard deviation score(HtSDS). In the three groups, we compared the HtSDS and △HtSDS at the start of treatment and during follow-up period and also compared the adult height and median parental height(MPH). We further compared the HtSDS classified by age and gender in imatinib group. At last, univariate analysis was used to analyze the influencing factors on the deceleration of height growth by imatinib.
There were 298 children in conventional chemotherapy group, 39 in imatinib group and 7 in dasatinib group. In imatinib group, the mean HtSDS of children at follow-up time was significantly lower than that at the start of treatment (P < 0.05), regardless of age and gender. In imatinib group, the decrease of HtSDS in girls was more obvious than in boys(P = 0.031). The HtSDS gradually decreased in the first and the second year in imatinib group. After discontinuation of imatinib, the HtSDS had no obvious change. Multivariate analysis showed that the HtSDS at the start of imatinib was negatively correlated with severe growth impairment on imatinib therapy. The HtSDS in dasatinib group and conventional chemotherapy group maintained a high degree of consistency.
Imatinib can affect growth velocity in children with ALL, regardless of age and gender. With the discontinuation of imatinib, the inhibitory effect will not continue. The lower HtSDS at the start of imatinib therapy, the more obvious effect of imatinib on growth impairment will be, and the effect will be more obvious in girls than boys.
探讨酪氨酸激酶抑制剂（TKIs）对急性淋巴细胞白血病（ALL）患儿身高生长的影响。
回顾性收集北京大学人民医院儿科收治的 344 例年龄小于 17 岁的 ALL 患儿资料，根据治疗方案分为常规化疗组、伊马替尼组和达沙替尼组。身高以标准差评分（HtSDS）表示。比较三组患儿治疗开始时、随访过程中的 HtSDS 及△HtSDS，比较成年身高及中位父母身高（MPH），比较伊马替尼组患儿按年龄、性别分类的 HtSDS。采用单因素分析方法分析伊马替尼致身高增长减速的影响因素。
常规化疗组 298 例，伊马替尼组 39 例，达沙替尼组 7 例。伊马替尼组患儿随访时的 HtSDS 明显低于治疗开始时（P<0.05），且与年龄、性别无关。伊马替尼组中，女孩 HtSDS 下降较男孩更明显（P=0.031）。伊马替尼组患儿 HtSDS 在治疗第 1、2 年逐渐下降，停药后 HtSDS 无明显变化。多因素分析显示，伊马替尼治疗开始时的 HtSDS 与伊马替尼治疗后严重生长损害呈负相关。达沙替尼组和常规化疗组的 HtSDS 高度一致。
伊马替尼可影响 ALL 患儿的生长速度，且与年龄、性别无关，停药后抑制作用不会持续。伊马替尼治疗开始时的 HtSDS 越低，伊马替尼对生长损害的影响越明显，且女性比男性更明显。
