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Post-Transplant Events

Growth hormone treatment impact on growth rate and final height of patients who received HSCT with TBI or/and cranial irradiation in childhood: a report from the French Leukaemia Long-Term Follow-Up Study (LEA)

Bone Marrow Transplantation volume 47, pages 684–693 (2012)Cite this article

Abstract

The literature contains a substantial amount of information about factors that adversely influence the linear growth in up to 85% of patients undergoing haematopoietic SCT (HSCT) with TBI and/or cranial irradiation (CI) for acute leukaemia (AL). By contrast, only a few studies have evaluated the impact of growth hormone (GH) therapy on growth rate and final height (FH) in these children. We evaluated growth rates during the pre- and post-transplant periods to FH in a group of 25 children treated with HSCT (n=22), TBI (n=21) or/and CI (n=8) for AL and receiving GH therapy. At the start of GH treatment, the median height Z-score was −2.19 (−3.95 to 0.02), significantly lower than at AL diagnosis (P<0.001). Overall height gain from start of GH treatment to FH was 0.59Z (−2.72 to 2.93) with a median height Z-score at FH of −1.35 (−5.35 to 0.27). This overall height gain effect was greater in girls than in boys (P=0.04). The number of children with heights in the reference population range was greater after than before GH therapy (P=0.07). At FH the GVHD and GH treatments lasting <2 years were associated with shorter FH (P=0.02 and 0.05). We found a measurable beneficial effect of GH treatment on growth up to FH.

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References

  1. Sanders JE, Guthrie KA, Hoffmeister PA, Woolfrey AE, Carpenter PA, Appelbaum FR . Final adult height of patients who received hematopoietic cell transplantation in childhood. Blood 2005; 105: 1348–1354.

    Article  CAS  Google Scholar 

  2. Sanders JE . Growth and development after hematopoietic cell transplant in children. Bone Marrow Transplant 2008; 41: 223–227.

    Article  CAS  Google Scholar 

  3. Bernard F, Bordigoni P, Simeoni MC, Barlogis V, Contet A, Loundou A et al. Height growth during adolescence and final height after haematopoietic SCT for childhood acute leukaemia: the impact of a conditioning regimen with BU or TBI. Bone Marrow Transplant 2009; 43: 637–642.

    Article  CAS  Google Scholar 

  4. Huma Z, Boulad F, Black P, Heller G, Sklar CA . Growth in children after bone marrow transplantation for acute leukemia. Blood 1995; 86: 819–824.

    CAS  PubMed  Google Scholar 

  5. Brauner R, Adan L, Souberbielle JC, Esperou H, Michon J, Devergie A et al. Contribution of growth hormone deficiency to the growth failure that follows bone marrow transplantation. J Pediatr 1997; 130: 785–792.

    Article  CAS  Google Scholar 

  6. Cohen A, Rovelli A, Bakker B, Uderzo C, Van Lint MT, Esperou H et al. Final height of patients who underwent bone marrow transplantation for hematological disorders during childhood: a study by the Working Party for Late Effects–EBMT. Blood 1999; 93: 4109–4115.

    CAS  PubMed  Google Scholar 

  7. Frisk P, Arvidson J, Gustafsson J, Lönnerholm G . Pubertal development and final height after autologous bone marrow trans plantation for acute leukemia. Bone Marrow Transplant 2004; 33: 205–210.

    Article  CAS  Google Scholar 

  8. Davies HA, Didcock E, Didi M, Ogilvy-Stuart A, Wales JK, Shalet SM . Growth, puberty and obesity after treatment for leukaemia. Acta Paediatr Suppl 1995; 411: 45–50.

    Article  CAS  Google Scholar 

  9. Sanders JE, Pritchard S, Mahoney P, Amos D, Buckner CD, Witherspoon RP et al. Growth and development following marrow transplantation for leukemia. Blood 1986; 68: 1129–1135.

    CAS  PubMed  Google Scholar 

  10. Borgström B, Bolme P . Growth and growth hormone in children after bone marrow transplantation. Horm Res 1988; 30: 98–100.

    Article  Google Scholar 

  11. Thomas ED, Clift RA, Hersman J, Sanders JE, Stewart P, Buckner CD et al. Marrow transplantation for acute nonlymphoblastic leukemic in first remission using fractionated or single-dose irradiation. Int J Radiat Oncol Biol Phys 1982; 8: 817–821.

    Article  CAS  Google Scholar 

  12. Brauner R, Fontoura M, Zucker JM, Devergie A, Souberbielle JC, Prevot-Saucet C et al. Growth and growth hormone secretion after bone marrow transplantation. Arch Dis Child 1993; 68: 458–463.

    Article  CAS  Google Scholar 

  13. Thomas BC, Stanhope R, Plowman PN, Leiper AD . Growth following single fraction and fractionated total body irradiation for bone marrow transplantation. Eur J Pediatr 1993; 152: 888–892.

    Article  CAS  Google Scholar 

  14. Leiper AD, Stanhope R, Lau T, Grant DB, Blacklock H, Chessells JM et al. The effect of total body irradiation and bone marrow transplantation during childhood and adolescence on growth and endocrine function. Br J Haematol 1987; 67: 419–426.

    Article  CAS  Google Scholar 

  15. Bakker B, Oostdijk W, Geskust RB, Stokvis-Brantsma WH, Vossen JM, Wit JM . Growth hormone (GH) secretion and response to GH therapy after total body irradiation and haematopoietic stem cell transplantation during childhood. Clin Endocrinol 2007; 67: 589–597.

    CAS  Google Scholar 

  16. Chemaitilly W, Boulad F, Heller G, Kernan NA, Small TN, O'Reilly RJ et al. Final height in pediatric patients after hyperfractionated total body irradiation and stem cell transplantation. Bone Marrow Transplant 2007; 40: 29–35.

    Article  CAS  Google Scholar 

  17. Leung W, Rose SR, Zhou Y, Hancock ML, Burstein S, Schriock EA et al. Outcomes of growth hormone replacement therapy in survivors of childhood acute lymphoblastic leukemia. J Clin Oncol 2002; 20: 2959–2964.

    Article  CAS  Google Scholar 

  18. Holm K, Nysom K, Rasmussen MH, Hertz H, Jacobsen N, Skakkebaek NE et al. Growth, growth hormone and final height after BMT: possible recovery of irradiation-induced growth hormone insufficiency. Bone Marrow Transplant 1996; 18: 163–170.

    CAS  PubMed  Google Scholar 

  19. Michel G, Bordigoni P, Simeoni MC, Curtillet C, Hoxha S, Robitail S et al. Health status and quality of life in long-term survivors of childhood leukaemia: the impact of haematopoietic stem cell transplantation. Bone Marrow Transplant 2007; 40: 897–904.

    Article  CAS  Google Scholar 

  20. Bordigoni P, Esperou H, Souillet G, Pico J, Michel G, Lacour B et al. Total body irradiation-high-dose cytosine arabinoside and melphalan followed by allogeneic bone marrow transplantation from HLA-identical siblings in the treatment of children with acute lymphoblastic leukaemia after relapse while receiving chemotherapy: a Societe Francaise de Greffe de Moelle study. Br J Haematol 1998; 102: 656–665.

    Article  CAS  Google Scholar 

  21. Vogelsang GB, Lee L, Bensen-Kennedy DM . Pathogenesis and treatment of graft-versus-host disease after bone marrow transplant. Annu Rev Med 2003; 54: 29–52.

    Article  CAS  Google Scholar 

  22. Sempé M, Pédron G, Roy-Pernot M-P . Auxologie, méthode et séquences. Théraplix: Paris, 1979, pp 124.

    Google Scholar 

  23. Dai QY, Souillet G, Bertrand Y, Galambrun C, Bleyzac N, Manel AM et al. Antileukemic and long-term effects of two regimens with or without TBI in allogeneic bone marrow transplantation for childhood acute lymphoblastic leukemia. Bone Marrow Transplant 2004; 34: 667–673.

    Article  CAS  Google Scholar 

  24. Couto-Silva AC, Trivin C, Esperou H, Michon J, Baruchel A, Lemaire P et al. Final height and gonad function after total body irradiation during childhood. Bone Marrow Transplant 2006; 38: 427–432.

    Article  Google Scholar 

  25. Clement-De Boers A, Oostdijk W, Van Weel-Sipman MH, Van den Broeck J, Wit JM, Vossen JM . Final height and hormonal function after bone marrow transplantation in children. J Pediatr 1996; 129: 544–550.

    Article  CAS  Google Scholar 

  26. Sklar CA, Mertens AC, Mitby P, Occhiogrosso G, Qin J, Heller G et al. Risk of disease recurrence and second neoplasms in survivors of childhood cancer treated with growth hormone: a report from the Childhood Cancer Survivor Study. J Clin Endocrinol Metab 2002; 87: 3136–3141.

    Article  CAS  Google Scholar 

  27. Ergun-Longmire B, Mertens AC, Mitby P, Qin J, Heller G, Shi W et al. Growth hormone treatment and risk of second neoplasms in the childhood cancer survivor. J Clin Endocrinol Metab 2006; 91: 3494–3498.

    Article  CAS  Google Scholar 

Download references

Acknowledgements

The cooperation of all participating teams in the LEA programme was greatly appreciated: Hématologie Pédiatrique APHP St Louis-Paris, Hématologie Pédiatrique APHP R Debré—Paris (Pr A Baruchel), Oncologie Pédiatrie APHP Trousseau—Paris (Pr G Leverger), Institut d'Hématologie et d'Oncologie Pédiatrique HCL—Lyon (Pr Y Bertrand), Hémato oncologie pédiatrique et greffe de moelle CHU—Nancy (Pr P Chastagner, Pr Bordigoni), CRCTCP CHU—Clermont-Ferrand (Pr F Deméocq), Hémato oncologie pédiatrique CHU—Nice (Dr N Sirvent), Hémato pédiatrique APHM La Timone—Marseille (Pr G Michel) Oncologie Pédiatrie CHU—Grenoble (Pr D Plantaz), Unité d'hémato-oncologie et greffes de moelle CHU-Rennes (Dr Virginie Gandemer). We thank Pr Pascal Auquier, Marie Claude Simeoni and their staff: EA3279 ‘Qualité de Vie et Maladies Chroniques’ Service de Santé Publique et Epidémiologie—Unité d'aide méthodologique à la Recherche clinique et épidémiologique, Marseille AP-HM, for database support.

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Authors and Affiliations

  1. CHU Clermont-Ferrand, Centre Régional de Cancérologie et Thérapie Cellulaire Pédiatrique, Hôpital Estaing, Clermont-Ferrand, France

    F Isfan, J Kanold, E Merlin, E Rochette & F Deméocq

  2. INSERM-CIC 501, Clermont-Ferrand, France

    F Isfan, J Kanold, E Merlin, E Rochette & F Deméocq

  3. Clermont Université, Univ Clermont1, Faculté de Médecine, Clermont-Ferrand, France

    F Isfan, J Kanold, E Merlin, E Rochette & F Deméocq

  4. CHU Nancy, Service d'Onco-Hématologie et Immunologie Pédiatrique—Hôpital Brabois, Nancy, France

    A Contet & P Chastagner

  5. CHU Nice, Service d'Hématologie Oncologie Pédiatrique, Hôpital Archet, Nice, France

    N Sirvent & M Poiree

  6. CHU Clermont-Ferrand, Pédiatrie Générale et Multidisciplinaire, Hôpital Estaing, Clermont-Ferrand, France

    D Terral & H Carla-Malpuech

  7. CHU Marseille, Service de Pédiatrie Multidisciplinaire—Hôpital d'Enfants de la Timone, Marseille, France

    R Reynaud

  8. CHU Clermont-Ferrand, DRCI, Biostatistics Unit, Clermont-Ferrand, France

    B Pereira

  9. Marseille Université, Faculté de Médecine, Service de Santé Publique, Marseille, France

    M C Simeoni & P Auquier

  10. CHU Marseille, Service de Pédiatrie et d'Hématologie Pédiatrique—Hôpital d'Enfants de la Timone, Marseille, France

    G Michel & F Deméocq

Authors
  1. F Isfan
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  2. J Kanold
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  3. E Merlin
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  9. H Carla-Malpuech
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  11. B Pereira
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  15. G Michel
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Correspondence to J Kanold.

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Isfan, F., Kanold, J., Merlin, E. et al. Growth hormone treatment impact on growth rate and final height of patients who received HSCT with TBI or/and cranial irradiation in childhood: a report from the French Leukaemia Long-Term Follow-Up Study (LEA). Bone Marrow Transplant 47, 684–693 (2012). https://doi.org/10.1038/bmt.2011.139

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