Shin Chungwoo, Jang Min Jeong, Kim Seongkoo, Lee Jae Wook, Chung Nack-Gyun, Cho Bin, Jung Min Ho, Suh Byung-Kyu, Ahn Moon Bae
Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Ann Pediatr Endocrinol Metab. 2023 Jun;28(2):116-123. doi: 10.6065/apem.2244028.014. Epub 2022 Jun 30.
Survivors of childhood leukemia are at risk of growth impairment due to intensive chemotherapy and radiation treatments. This study investigated the auxological and biochemical characteristics of childhood leukemia survivors diagnosed with growth hormone deficiency (GHD) and the changes in these parameters after 1 year of growth hormone (GH) treatment.
A total of 24 children diagnosed with GHD after leukemia treatment was analyzed. Clinical and biochemical data were collected retrospectively at leukemia diagnosis, GHD diagnosis, and 1 year after GH treatment. Standard deviation score (SDS) was calculated based on the age- and gender-adjusted population.
Of the 24 children included in this study, 19 received GH treatment. The median age at GHD diagnosis was 12.3 years, and the median delay in bone age was 1.46 years. Height SDS decreased from -0.69 at leukemia diagnosis to -2.58 at GHD diagnosis (P<0.001). The change in height SDS with and without GH for 1 year was 0.35 and -0.21, respectively (P=0.044). In regression analyses, higher height SDS at GHD diagnosis and a smaller decrease of the height SDS between leukemia and GHD diagnoses were positively correlated with height SDS after GH treatment.
GH treatment could be beneficial and safe for improving height in childhood leukemia survivors with GHD. Height SDS at GHD diagnosis and reduction of height SDS between leukemia and GHD diagnosis could be potential factors in predicting the therapeutic effects. Close auxological monitoring is recommended for any childhood leukemia survivors who experience posttreatment height decline.
由于强化化疗和放射治疗,儿童白血病幸存者存在生长发育受损的风险。本研究调查了被诊断为生长激素缺乏症(GHD)的儿童白血病幸存者的体格学和生化特征,以及生长激素(GH)治疗1年后这些参数的变化。
对总共24名白血病治疗后被诊断为GHD的儿童进行了分析。回顾性收集白血病诊断时、GHD诊断时以及GH治疗1年后的临床和生化数据。根据年龄和性别调整后的人群计算标准差评分(SDS)。
本研究纳入的24名儿童中,19名接受了GH治疗。GHD诊断时的中位年龄为12.3岁,骨龄的中位延迟为1.46岁。身高SDS从白血病诊断时的-0.69降至GHD诊断时的-2.58(P<0.001)。接受和未接受GH治疗1年时身高SDS的变化分别为0.35和-0.21(P=0.044)。在回归分析中,GHD诊断时较高的身高SDS以及白血病和GHD诊断之间身高SDS较小的下降与GH治疗后的身高SDS呈正相关。
GH治疗对于改善患有GHD的儿童白血病幸存者的身高可能是有益且安全的。GHD诊断时的身高SDS以及白血病和GHD诊断之间身高SDS的降低可能是预测治疗效果的潜在因素。对于任何经历治疗后身高下降的儿童白血病幸存者,建议进行密切的体格学监测。