Author/Editor		Bratanič, Nina; Uršič-Bratina, Nataša; Žerjav-Tanšek, Mojca; Jazbec, Janez; Zaletel-Zadravec, Lorna; Kržišnik, Ciril; Battelino, Tadej
Title		Final height and body mass index after treatment for childhood acute lymphoblastic leukemia
Translated title		Končna višina in indeks telesne mase pri bolnikih, zdravljenih zaradi akutne limfoblastne levkemije v otroštvu
Type		članek
Source		Zdrav Vestn
Vol. and No.		Letnik 75, št. 3
Publication year		2006
Volume		str. 145-50
Language		eng
Abstract		Newer and more agressive forms of chemotherapy and newer protocols in the treatment have increased the survival rate of children with malignancies. Improved survival rates in children treated for acute lymphoblastic leukemia have focused attention on late effects including disorders of growth and puberty, and development of overweight or obesity. The height and weight expressed as body mass index (BMI) of 47 patients (29 girls, 18 boys) long-term survivors of childhood lymphoblastic leukemia was retrospectively analyzed. Height standard deviation score (HSDS) according to Tanner and body mass index standard deviation scores (BMISDS) before treatment and at follow-up were calculated. At the time of analysis all patients remained in first remission. Twenty-eight patients had cranial radiation with Z2-Z8 Gy and 15 with 20-30 Gy. Four patients had no radiotherapy. All patients were treated with standard chemotherapy including intrathecal Methotrexat. Mean age (SD) at the diagnosis was 5 5/12 (3 2/12) years, range (5/12 - 125/12) and at the time of evaluation 17 11/12 (3 9/12) years, range (10 1/12 - 31 6/12). We observed significant decrease in HSDS from diagnosis to the final height in both radiation groups (p < 0.01) but the decrement in final height was similar with both radiation dose regimens. The decrement in final height SDS was greater in patients treated at a younger age (Pearson, p < 0. OZ). Girls treated with higher radiation dose (20-30 Gy) were more severely affected than boys. In both radiation dose treatment groups there was a significant increase in BMISDS between diagnosis and final height (p < 0.0001) with no significant difference between treatment groups. Menarche occurred earlier in girls than normal with no significant difference between both radiation dose regimens. We observed significant deterioration in HSDS and increment in BMISDS regardless to the radiation dose.
Summary		Z razvojem novih kemoterapevtikov in shem zdravjenja se preživetje in živjenjska doba bolnikov z rakom povečujeta. S spremljanjem bolnikov se veča znanje o možnih poznih stranskih učinkih zdravljenja. Pri otrocih in mladostnikih, zdravljenih zaradi akutne limfoblastne levkemije, lahko kemoterapija in obsevanje vplivata tudi na rast in pubertetni razvoj ter nastanek čezmerne prehranjenosti ali debelosti. Retrospektivno smo analizirali končno telesno višino in maso, izraženo kot indeks telesne mase (ITM), pri 47 bolnikih (29 deklicah), ki so se zdravili na Onkološkem oddelku Pediatrične klinike zaradi akutne limfoblastne levkemije v otroštvu. Telesno višino in ITM smo izrazili kot standardni odklon od povprečja za starost in spol in primerjali vrednosti pred začetkom zdravljenja in ob končni telesni višini. V času raziskave so bili vsi preiskovanci v prvi remisiji bolezni. Osemindvajset bolnikov je prejelo profilaktično obsevanje osrednjega živčevja v skupnem odmerku 12-18 Gy in 15 v skupnem odmerku 20-30 Gy. Štirje preiskovanci niso prejeli profilaktičnega obsevanja. Vsi preiskovanci so prejeli kemoterapijo po standardnih protokolih ter intratekalnimi aplikacijami metotreksata. Ob diagnozi je bila povprečna starost (standardni odklon) preiskovancev 5 5/12 (3 2/12) let, razpon od (5/12 - 12 5/12), v času raziskave pa 17 11/12 (3 9/12) let, razpon od (10 1 /12 - 31 6/12). (Izvleček skrajšan na 2000 znakov)
Descriptors		BODY HEIGHT BODY MASS INDEX LEUKEMIA, LYMPHOCYTIC, ACUTE PUBERTY