Decreased adult height in survivors of childhood acute lymphoblastic leukemia: a report from the Childhood Cancer Survivor Study.

Chow EJ, Friedman DL, Yasui Y, Whitton JA, Stovall M, Robison LL, Sklar CA
J Pediatr. 2007 150 (4): 370-5, 375.e1

PMID: 17382112 · PMCID: PMC2766352 · DOI:10.1016/j.jpeds.2006.11.036

OBJECTIVE - To determine risk factors associated with reduced adult height in survivors of childhood acute lymphoblastic leukemia (ALL).

STUDY DESIGN - This was a cross-sectional study. Attained adult height was determined among 2434 ALL survivors participating in the Childhood Cancer Survivor Study, a cohort of 5-year survivors of common pediatric cancers diagnosed from 1970 to 1986, and compared with 3009 siblings.

RESULTS - All survivor treatment exposure groups (chemotherapy alone, chemotherapy with cranial or craniospinal radiotherapy) had decreased adult height and an increased risk of adult short stature (height standard deviation score < -2) compared with siblings (P < .001). Compared with siblings, the risk of short stature for survivors treated with chemotherapy alone was elevated (OR, 3.4; 95% CI, 1.9, 6.0). Among survivors, significant risk factors for short stature included diagnosis of ALL before puberty, higher-dose cranial radiotherapy (> or = 20 Gy versus < 20 Gy), any radiotherapy to the spine, and female sex.

CONCLUSIONS - Survivors of childhood ALL are at increased risk of adult short stature, including those treated with chemotherapy alone. Risk is highest for those treated with cranial and craniospinal radiotherapy at a young age.

MeSH Terms (29)

Adolescent Adult Age Factors Age of Onset Antineoplastic Agents Body Height Canada Child Child, Preschool Child Development Cohort Studies Combined Modality Therapy Cross-Sectional Studies Dose-Response Relationship, Drug Dose-Response Relationship, Radiation Female Humans Infant Infant, Newborn Male Middle Aged Precursor Cell Lymphoblastic Leukemia-Lymphoma Puberty Radiotherapy Risk Factors Sex Factors Siblings Survivors United States

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