KMID : 0387820110180010019
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Clinical Pediatric Hematology-Oncology 2011 Volume.18 No. 1 p.19 ~ p.26
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Growth Patterns in Patients with Acute Leukemia after Allogeneic Stem Cell Transplantation
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Chueh Hee-Won
Lee Soo-Hyun Yoo Keon-Hee Sung Ki-Woong Koo Hong-Hoe
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Abstract
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Background: Growth of the children who received allogeneic stem cell transplantation (allo-SCT) is known to be impaired. We analyzed the patterns of growth in long-term survivors of acute leukemia who are disease free more than 5 years after allo-SCT.
Methods: Heights and weights of 55 patients with acute leukemia who received allo-SCT between January 1999 and December 2005 in Samsung Medical Center, and who are alive without disease, were assessed. Heights and weights of the patients¡¯ parents were assessed to compare with the patients¡¯ growth.
Results: 24 patients with acute lymphoblastic leukemia, 5 patients with acute biphenotypic leukemia, and 26 patients with acute myeloid leukemia have been followed up during 97 months (63-176 months). All patients had decreased final height Z-score and weight Z-score (height, male, -1.273 (-2.383-1.53), female -0.871 (-2.398-0.827), weight, -0.976 (-4.532-2.706) and -0.949 (-3.695-1.856), respectively). Final height of 23 patients aged over 18 was 165.0 cm (157.1-174.9) in male, and 156.9 cm (149.2-165.1) in female patients. Final height was decreased compared to their mid-parental height (male, 171.0 cm (167.5-178.0 cm), P=0.003, female, 160.0 cm (156.0-161.0 cm), P=0.460). Total body irradiation (TBI) and age at diagnosis was the risk factor for decreased final height. But others didn¡¯t affect to adult height. Nineteen (34.5%) patients have been treated for various endocrine problem, and 12 (21.8%) had other complications.
Conclusion: Patients with acute leukemia treated with allo-SCT had decrease in final growth, and had many other medical problems. Further efforts to evaluate and manage these problems are desperately needed.
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KEYWORD
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Leukemia, Hematopoietic Stem Cell Transplantation, Growth
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