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Pediatric Transplants

Final height and gonad function after total body irradiation during childhood

Bone Marrow Transplantation volume 38, pages 427–432 (2006)Cite this article

Abstract

Short stature and gonad failure can be a side effect of total body irradiation (TBI). The purpose of the study was to evaluate the factors influencing final height and gonad function after TBI. Fifty young adults given TBI during childhood were included. Twenty-seven had been treated with growth hormone (GH). Those given single 10 Grays (Gy) or fractionated 12 Gy TBI had similar characteristics, GH peaks, final heights and gonad function. After the end of GH treatment, 11/20 patients evaluated had GH peak >10 μg/l. Final height was <−2s.d. in 29 (58%). The height loss between TBI and final height (2.4±1.1 s.d.) was greater in those who were younger when irradiated (P<0.0001). When the GH-treated and -untreated patients were analyzed separately, this loss was correlated with the age at TBI at 4–8 years for the GH-treated and at 6–8 years for the untreated. Boys showed negative correlations between testicular volume and plasma follicle-stimulating hormone (FSH, P=0.0008) and between plasma FSH and inhibin B (P=0.005) concentrations. We concluded that the indications for GH treatment should be mainly based on the age at irradiation, taking into account the GH peak. The plasma FSH and inhibin B concentrations may predict sperm function.

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References

  1. Adan L, de Lanversin M-L, Thalassinos C, Souberbielle J-C, Fischer A, Brauner R . Growth after bone marrow transplantation in young children conditioned with chemotherapy alone. Bone Marrow Transplant 1997; 19: 253–256.

    Article  CAS  PubMed  Google Scholar 

  2. Cohen A, Rovelli A, Bakker B, Uderzo C, Van Lint M-T, Espérou 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 

  3. Cohen A, Rovelli A, Van-Lint M-T, Uderzo C, Morchio A, Pezzini C et al. Final height of patients who underwent bone marrow transplantation during childhood. Arch Dis Child 1996; 74: 437–440.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. 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 

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

    Article  CAS  PubMed  Google Scholar 

  6. 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  PubMed  Google Scholar 

  7. Bakker B, Massa GG, Oostdijk W, Van Weel-Sipman MH, Vossen JM, Wit JM . Pubertal development and growth after total-body irradiation and bone marrow transplantation for haematological malignancies. Eur J Pediatr 2000; 159: 31–37.

    Article  CAS  PubMed  Google Scholar 

  8. Fletcher BD, Crom DB, Krance RA, Kun RE . Radiation-induced bone abnormalities after bone marrow transplantation for childhood leukemia. Radiology 1994; 191: 231–235.

    Article  CAS  PubMed  Google Scholar 

  9. Brauner R, Adan L, Souberbielle JC, Espérou 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  PubMed  Google Scholar 

  10. Couto-Silva A-C, Trivin C, Adan L, Lawson-Body E, Souberbielle J-C, Brauner R . Management of boys with short stature and delayed puberty. J Pediatr Endocrinol Metab 2005; 18: 807–814.

    Article  CAS  PubMed  Google Scholar 

  11. Sempe M, Pedron G, Roy Pernot MP . Auxologie, Méthode et Sequences. Theraplix ed.: Paris 1979.

  12. Rolland-Cachera MF, Cole TJ, Sempé M, Tichet J, Rossignol C, Charraud A . Body mass1 index variations: centiles from birth to 87 years. Eur J Clin Nutr 1991; 45: 13–21.

    CAS  PubMed  Google Scholar 

  13. Burr IM, Sizonenko PC, Kaplan SL, Grumbach MM . Hormonal changes during puberty. I. Correlation of serum luteinizing hormone and follicle-stimulating hormone with stages of puberty, testicular size, and bone age in normal boys. Pediatr Res 1970; 4: 25–35.

    Article  CAS  PubMed  Google Scholar 

  14. Tanner JM, Goldstein H, Whitehouse RH . Standards for children's height at ages 2–9 years allowing for heights of parents. Arch Dis Child 1970; 45: 755–762.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Andersson AM, Juul A, Petersen JH, Müller J, Groome P, Skakkebaek NE . Serum inhibin B in healthy pubertal and adolescent boys: relation to age, stage of puberty, and follicle-stimulating hormone, luteinizing hormone, testosterone, and estradiol levels. J Clin Endocr Metab 1997; 82: 3976–3981.

    CAS  PubMed  Google Scholar 

  16. Boros E, Hammer PL, Ibaraki T, Kogan A, Mayoraz E, Muchnick I . An implementation of logical analysis of data. IEEE Trans Knowledge and Data Eng 2000; 12: 292–306.

    Article  Google Scholar 

  17. Brennan B, Shalet SM . Endocrine late effects after bone marrow transplant. Br J Hematol 2002; 118: 58–66.

    Article  Google Scholar 

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

    Article  CAS  PubMed  Google Scholar 

  19. Thibault H, Souberbielle JC, Taieb C, Brauner R . Idiopathic prepubertal short stature is associated with low body mass index. Horm Res 1993; 40: 136–140.

    Article  CAS  PubMed  Google Scholar 

  20. Wudy SA, Hagemann S, Dempfle A, Ringler G, Blum WF, Berthold LD et al. Children with idiopathic prepubertal short stature are poor eaters and have decreased body mass index. Pediatrics 2005; 116: e52–e57.

    Article  PubMed  Google Scholar 

  21. Couto-Silva AC, Trivin C, Esperou H, Michon J, Fisher A, Brauner R . Changes in weight and plasma leptin after bone marrow transplantation. Bone Marrow Transplant 2000; 26: 1205–1210.

    Article  CAS  PubMed  Google Scholar 

  22. Taskinen M, Saarinen-Pihkala UM . Increase in height during the first year after bone marrow transplantation reflecting nutritional status of children. Bone Marrow Transplant 1998; 22: 689–692.

    Article  CAS  PubMed  Google Scholar 

  23. Petersen PM, Andersson AM, Rorth M, Daugaard G, Skakkebaek NE . Undetectable inhibin B serum levels in men after testicular irradiation. J Clin Endocr Metab 1999; 84: 213–215.

    CAS  PubMed  Google Scholar 

  24. Sanders JE, Hawley J, Levy W, Gooley T, Buckner CD, Deeg J et al. Pregnancies following high dose cyclophosphamide with or without high-dose busulfan or total body irradiation and bone marrow transplantation. Blood 1996; 87: 3045–3052.

    CAS  PubMed  Google Scholar 

  25. Holm K, Nysom K, Brocks V, Hertz H, Jacobsen N, Müller J . Ultrasound B-mode changes in the uterus and ovaries and Doppler changes in the uterus after total body irradiation and allogenic bone marrow transplantation in childhood. Bone Marrow Transplant 1999; 23: 259–263.

    Article  CAS  PubMed  Google Scholar 

  26. Larsen EC, Müller J, Schmiegelow K, Rechnitzer C, Nboye Andersen A . Reduced ovarian function in long-term survivors of radiation- and chemotherapy-treated childhood cancer. J Clin Endocr Metab 2003; 88: 5307–5314.

    Article  CAS  PubMed  Google Scholar 

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Acknowledgements

We thank Louis-Philippe Kroniek and Nadia Brauner, Laboratoire Leibniz-IMAG, Grenoble, for their help with data analysis, Marie-Annick Huin, Marie-Christine Perret and Monique Pouillot for technical help and Dr Owen Parkes for editing the manuscript.

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Author notes

  1. A-C Couto-Silva

    Present address: Center of Diabetes and Endocrinology of Bahia (CEDEBA), Brazil

Authors and Affiliations

  1. Université Paris-Descartes, Unité d'endocrinologie pédiatrique, AP-HP, Hôpital Bicêtre, Le Kremlin Bicêtre, France

    A-C Couto-Silva & R Brauner

  2. AP-HP, Service d'explorations fonctionnelles, Hôpital Necker-Enfants Malades, Paris, France

    C Trivin

  3. AP-HP, Service des greffes de moelle, Hôpital Saint Louis, Paris, France

    H Esperou

  4. Département d'oncologie pédiatrique, Institut Curie, Paris, France

    J Michon

  5. Service d'hématologie pédiatrique, Université Lariboisière-Saint-Louis, Paris, France

    A Baruchel

  6. Laboratoire TIMC-IMAG, CNRS/UJF, Grenoble, France

    P Lemaire

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  1. A-C Couto-Silva
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Correspondence to R Brauner.

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Couto-Silva, AC., Trivin, C., Esperou, H. et al. Final height and gonad function after total body irradiation during childhood. Bone Marrow Transplant 38, 427–432 (2006). https://doi.org/10.1038/sj.bmt.1705455

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