Final Height and Body Mass Index After Fractionated Total Body Irradiation and Allogeneic Stem Cell Transplantation in Childhood Leukemia

Abstract

Impaired linear growth has been reported in patients treated during childhood with allogeneic stem cell transplantation and fractionated total body irradiation (fTBI). The objective of this study was to determine the final height and body mass index (BMI) achieved. Forty-nine patients with leukemia were included and surveyed for more than 5 years. Median age at follow-up was 24.3 years (range, 18.9–35.8) and median follow-up time from allograft was 14.4 years (range, 4.5–21.9). Mean height standard deviation score (s.d.s.) at final examination (−1.1 ± 1.3,) was significantly lower than at fTBI (0.3 ± 1.2; P = .001). Final height s.d.s. was significantly correlated with age at diagnosis, age at fTBI, and target height (P = .001; P < .001; P < .001, respectively). Final height was significantly lower in children transplanted before age 5 (P = .006). Growth hormone treatment (n = 6) had only a modest effect on growth velocity. Mean BMI at follow-up was normal at 19.6 kg/m² for boys and 21.2 for girls, but with a significant decrease since allograft only for boys (−1.2 ± 1.5 s.d.s.) (P = .003). In conclusion, final height is decreased; BMI is normal but decreased from fTBI in boys.

Keywords :

• allogeneic stem cell transplantation
• body mass index
• childhood leukemia
• final height
• fractionated total body irradiation