Abstract
We have studied 31 girls with ALL who have been treated with prophylactic 1800 - 2400 cGy to the cranial meninges; 3 girls had further cranial irradiation following relapse. All had been treated with intrathecal Methotrexate in addition to systemic chemotherapy. Mean age of onset of puberty was 8.4 yrs (range 6.7 - 10.0); 5 had precocious puberty. Early puberty as a sequelae of prophylactic low-dose cranial irradiation occurcd predominantly in girls, which is compatible with our hypothesis for the mechanism of the timing of the onset of sexual maturation.
21 girls had an absent or inadequate growth acceleration of puberty. Pharmacological tests of GH secretion were unreliable at diagnosing GH insufficiency, not least because standards for GH secretion in normal puberty were not available. Early or precocious puberty combined with GH insufficiency may produce severe growth failure and we have used a treatment regimen of either intranasal (D-Scr6) GnRH or Depot (D-Trp6) GnRH in combination with biosynthetic Met-GH. We have been able to compare the treatment of 10 girls treated by this combined regimen for up to 1.5 yrs with 19 girls who had no endocrine therapy. The rate of advancement of epiphyseal maturation slowed and growth rate increased during treatment, although longer treatment periods will be required to assess the affect on final height.
Article PDF
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Leiper, A., Stanhope, R., Preece, M. et al. 4 PRECOCIOUS OR EARLY PUBERTY AND GROWTH FAILURE IN GIRLS TREATED FOR ACUTE LYMPHOBLASTIC LEUKAEMIA. Pediatr Res 24, 517 (1988). https://doi.org/10.1203/00006450-198810000-00025
Issue Date:
DOI: https://doi.org/10.1203/00006450-198810000-00025