Growth in children after bone marrow transplantation

Mauro Bozzola, Giovanna Giorgiani, Franco Locatelli, Mariangela Cisternino, Daniela Gambarana, Marco Zecca, Francesco Torcetta, Francesco Severi

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Growth velocity pattern and growth hormone (GH) secretion were evaluated in 18 prepubertal patients (13 males, 5 females), receiving an allogeneic (7 patients) or autologous (11 patients) bone marrow transplantation (BMT). Children were affected by oncological or hematological malignancies and the age range was between 2 and 11 years. Nine patients received a conditioning regimen consisting of chemotherapy and fractionated total body irradiation (TBI) (12 Gy in 6 fractions over 3 days), whereas 9 children also received previous prophylactic cranial irradiation during first-line chemotherapy. GH secretion in response to pharmacological stimuli (insulin, arginine and/or L-Dopa) was evaluated when growth failure occurred. The 9 prepubertal patients who had received previous prophylactic cranial irradiation during first-line chemotherapy, showed a significant decrease in growth rate already 1 year after BMT and this reduced growth rate presented a progressive further decrease in the 2nd and 3rd year after BMT. On the contrary, in the 9 prepubertal children treated with TBI and chemotherapy alone, growth rate presented an impressive decrease only during the 3rd year. In the two groups of patients, pretransplantation growth rates were comparable, while, due to the earlier growth failure in children receiving TBI and previous prophylactic cranial irradiation, mean standard deviation score (SDS) significantly differed at 1 and 2 years following BMT. Such a difference disappeared at 3 years after BMT, because of the late decrease in growth rate in patients given TBI and chemotherapy alone. GH deficiency was demonstrated in 8 out of the 9 patients receiving TBI and previous prophylactic cranial irradiation 0.5-2 years after BMT and in 7 of the 9 children given TBI and chemotherapy alone 3-4.5 years following BMT. Seven children were treated with human recombinant GH (0.6 U/kg/week s.c). A successful response to hormonal replacement therapy was observed over the first year of treatment in 5 children. Our data demonstrate that fractionated TBI has a deleterious effect on growth velocity and GH secretion. Prophylactic cranial irradiation during first-line chemotherapy results in an earlier occurrence of growth impairment. Children showing GH deficiency after BMT can respond to GH treatment with an increase in height velocity similar to that observed in patients with idiopathic GH deficiency.

Original languageEnglish
Pages (from-to)122-126
Number of pages5
JournalHormone Research in Paediatrics
Volume39
Issue number3-4
DOIs
Publication statusPublished - 1993

Fingerprint

Bone Marrow Transplantation
Whole-Body Irradiation
Growth Hormone
Cranial Irradiation
Growth
Drug Therapy
Human Growth Hormone
Levodopa
Hematologic Neoplasms
Arginine
Therapeutics
Pharmacology
Insulin

Keywords

  • Bone marrow transplantation
  • Growth
  • Growth hormone

ASJC Scopus subject areas

  • Endocrinology
  • Endocrinology, Diabetes and Metabolism
  • Pediatrics, Perinatology, and Child Health

Cite this

Growth in children after bone marrow transplantation. / Bozzola, Mauro; Giorgiani, Giovanna; Locatelli, Franco; Cisternino, Mariangela; Gambarana, Daniela; Zecca, Marco; Torcetta, Francesco; Severi, Francesco.

In: Hormone Research in Paediatrics, Vol. 39, No. 3-4, 1993, p. 122-126.

Research output: Contribution to journalArticle

Bozzola, Mauro ; Giorgiani, Giovanna ; Locatelli, Franco ; Cisternino, Mariangela ; Gambarana, Daniela ; Zecca, Marco ; Torcetta, Francesco ; Severi, Francesco. / Growth in children after bone marrow transplantation. In: Hormone Research in Paediatrics. 1993 ; Vol. 39, No. 3-4. pp. 122-126.
@article{b70264d3e2ef40529d6ea95e2ca37341,
title = "Growth in children after bone marrow transplantation",
abstract = "Growth velocity pattern and growth hormone (GH) secretion were evaluated in 18 prepubertal patients (13 males, 5 females), receiving an allogeneic (7 patients) or autologous (11 patients) bone marrow transplantation (BMT). Children were affected by oncological or hematological malignancies and the age range was between 2 and 11 years. Nine patients received a conditioning regimen consisting of chemotherapy and fractionated total body irradiation (TBI) (12 Gy in 6 fractions over 3 days), whereas 9 children also received previous prophylactic cranial irradiation during first-line chemotherapy. GH secretion in response to pharmacological stimuli (insulin, arginine and/or L-Dopa) was evaluated when growth failure occurred. The 9 prepubertal patients who had received previous prophylactic cranial irradiation during first-line chemotherapy, showed a significant decrease in growth rate already 1 year after BMT and this reduced growth rate presented a progressive further decrease in the 2nd and 3rd year after BMT. On the contrary, in the 9 prepubertal children treated with TBI and chemotherapy alone, growth rate presented an impressive decrease only during the 3rd year. In the two groups of patients, pretransplantation growth rates were comparable, while, due to the earlier growth failure in children receiving TBI and previous prophylactic cranial irradiation, mean standard deviation score (SDS) significantly differed at 1 and 2 years following BMT. Such a difference disappeared at 3 years after BMT, because of the late decrease in growth rate in patients given TBI and chemotherapy alone. GH deficiency was demonstrated in 8 out of the 9 patients receiving TBI and previous prophylactic cranial irradiation 0.5-2 years after BMT and in 7 of the 9 children given TBI and chemotherapy alone 3-4.5 years following BMT. Seven children were treated with human recombinant GH (0.6 U/kg/week s.c). A successful response to hormonal replacement therapy was observed over the first year of treatment in 5 children. Our data demonstrate that fractionated TBI has a deleterious effect on growth velocity and GH secretion. Prophylactic cranial irradiation during first-line chemotherapy results in an earlier occurrence of growth impairment. Children showing GH deficiency after BMT can respond to GH treatment with an increase in height velocity similar to that observed in patients with idiopathic GH deficiency.",
keywords = "Bone marrow transplantation, Growth, Growth hormone",
author = "Mauro Bozzola and Giovanna Giorgiani and Franco Locatelli and Mariangela Cisternino and Daniela Gambarana and Marco Zecca and Francesco Torcetta and Francesco Severi",
year = "1993",
doi = "10.1159/000182711",
language = "English",
volume = "39",
pages = "122--126",
journal = "Hormone Research in Paediatrics",
issn = "1663-2818",
publisher = "S. Karger AG",
number = "3-4",

}

TY - JOUR

T1 - Growth in children after bone marrow transplantation

AU - Bozzola, Mauro

AU - Giorgiani, Giovanna

AU - Locatelli, Franco

AU - Cisternino, Mariangela

AU - Gambarana, Daniela

AU - Zecca, Marco

AU - Torcetta, Francesco

AU - Severi, Francesco

PY - 1993

Y1 - 1993

N2 - Growth velocity pattern and growth hormone (GH) secretion were evaluated in 18 prepubertal patients (13 males, 5 females), receiving an allogeneic (7 patients) or autologous (11 patients) bone marrow transplantation (BMT). Children were affected by oncological or hematological malignancies and the age range was between 2 and 11 years. Nine patients received a conditioning regimen consisting of chemotherapy and fractionated total body irradiation (TBI) (12 Gy in 6 fractions over 3 days), whereas 9 children also received previous prophylactic cranial irradiation during first-line chemotherapy. GH secretion in response to pharmacological stimuli (insulin, arginine and/or L-Dopa) was evaluated when growth failure occurred. The 9 prepubertal patients who had received previous prophylactic cranial irradiation during first-line chemotherapy, showed a significant decrease in growth rate already 1 year after BMT and this reduced growth rate presented a progressive further decrease in the 2nd and 3rd year after BMT. On the contrary, in the 9 prepubertal children treated with TBI and chemotherapy alone, growth rate presented an impressive decrease only during the 3rd year. In the two groups of patients, pretransplantation growth rates were comparable, while, due to the earlier growth failure in children receiving TBI and previous prophylactic cranial irradiation, mean standard deviation score (SDS) significantly differed at 1 and 2 years following BMT. Such a difference disappeared at 3 years after BMT, because of the late decrease in growth rate in patients given TBI and chemotherapy alone. GH deficiency was demonstrated in 8 out of the 9 patients receiving TBI and previous prophylactic cranial irradiation 0.5-2 years after BMT and in 7 of the 9 children given TBI and chemotherapy alone 3-4.5 years following BMT. Seven children were treated with human recombinant GH (0.6 U/kg/week s.c). A successful response to hormonal replacement therapy was observed over the first year of treatment in 5 children. Our data demonstrate that fractionated TBI has a deleterious effect on growth velocity and GH secretion. Prophylactic cranial irradiation during first-line chemotherapy results in an earlier occurrence of growth impairment. Children showing GH deficiency after BMT can respond to GH treatment with an increase in height velocity similar to that observed in patients with idiopathic GH deficiency.

AB - Growth velocity pattern and growth hormone (GH) secretion were evaluated in 18 prepubertal patients (13 males, 5 females), receiving an allogeneic (7 patients) or autologous (11 patients) bone marrow transplantation (BMT). Children were affected by oncological or hematological malignancies and the age range was between 2 and 11 years. Nine patients received a conditioning regimen consisting of chemotherapy and fractionated total body irradiation (TBI) (12 Gy in 6 fractions over 3 days), whereas 9 children also received previous prophylactic cranial irradiation during first-line chemotherapy. GH secretion in response to pharmacological stimuli (insulin, arginine and/or L-Dopa) was evaluated when growth failure occurred. The 9 prepubertal patients who had received previous prophylactic cranial irradiation during first-line chemotherapy, showed a significant decrease in growth rate already 1 year after BMT and this reduced growth rate presented a progressive further decrease in the 2nd and 3rd year after BMT. On the contrary, in the 9 prepubertal children treated with TBI and chemotherapy alone, growth rate presented an impressive decrease only during the 3rd year. In the two groups of patients, pretransplantation growth rates were comparable, while, due to the earlier growth failure in children receiving TBI and previous prophylactic cranial irradiation, mean standard deviation score (SDS) significantly differed at 1 and 2 years following BMT. Such a difference disappeared at 3 years after BMT, because of the late decrease in growth rate in patients given TBI and chemotherapy alone. GH deficiency was demonstrated in 8 out of the 9 patients receiving TBI and previous prophylactic cranial irradiation 0.5-2 years after BMT and in 7 of the 9 children given TBI and chemotherapy alone 3-4.5 years following BMT. Seven children were treated with human recombinant GH (0.6 U/kg/week s.c). A successful response to hormonal replacement therapy was observed over the first year of treatment in 5 children. Our data demonstrate that fractionated TBI has a deleterious effect on growth velocity and GH secretion. Prophylactic cranial irradiation during first-line chemotherapy results in an earlier occurrence of growth impairment. Children showing GH deficiency after BMT can respond to GH treatment with an increase in height velocity similar to that observed in patients with idiopathic GH deficiency.

KW - Bone marrow transplantation

KW - Growth

KW - Growth hormone

UR - http://www.scopus.com/inward/record.url?scp=0027384559&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0027384559&partnerID=8YFLogxK

U2 - 10.1159/000182711

DO - 10.1159/000182711

M3 - Article

C2 - 8262472

AN - SCOPUS:0027384559

VL - 39

SP - 122

EP - 126

JO - Hormone Research in Paediatrics

JF - Hormone Research in Paediatrics

SN - 1663-2818

IS - 3-4

ER -