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Growth Post Transplant

Growth and endocrine function in children with acute myeloid leukaemia after bone marrow transplantation using busulfan/cyclophosphamide

Abstract

Longitudinal studies of growth and endocrine function of children with AML transplanted with BUCY are limited. We report a cohort of 23 children with AML transplanted (15 autologous and eight allogeneic) following a single chemotherapy protocol and surviving at least 2 years after BMT. Busulfan was given as a single daily dose. Growth and endocrine function was evaluated yearly from one up to 10 years post transplant (median 4.9 years). The mean height standard deviation score (HtSDS) of the entire group decreased from 0.01 (s.e.m. ± 0.25) at diagnosis to –0.38 (± 0.28) at BMT (P = 0.001). There was no statistically significant difference between HtSDS at BMT and yearly HtSDS from 1 to 5 years post BMT. There was no significant relationship between age at BMT and subsequent change in HtSDS. To date, five of six girls have needed sex steroid replacement. Six of 12 evaluable boys had abnormal gonadotrophins, but none required sex steroid replacement. Children with AML who undergo BMT with BUCY show no significant growth impairment, but gonadal dysfunction is prominent, particularly in girls. Bone Marrow Transplantation (2000) 25, 1087–1092.

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References

  1. Cohen A, Rovelli R, Zecca S et al. Endocrine late effects in children who underwent bone marrow transplantation: review Bone Marrow Transplant 1998 21: (Suppl. 2) S64–S67

    PubMed  Google Scholar 

  2. Stevens RF, Hann IM, Wheatley K et al. Marked improvement in outcome with chemotherapy alone in paediatric acute myeloid leukaemia: results of the United Kingdom Medical Research Council's 10th AML trial Br J Haematol 1998 101: 130–140

    Article  CAS  Google Scholar 

  3. Shaw PJ, Bergin ME, Burgess MA et al. Childhood acute myeloid leukaemia; outcome in a single centre using chemotherapy and consolidation with busulfan/cyclophosphamide for bone marrow transplantation J Clin Oncol 1994 12: 2138–2145

    Article  CAS  Google Scholar 

  4. Giorgiani G, Bozzola M, Locatelli F et al. Role of busulfan and total body irradiation on growth of prepubertal children receiving bone marrow transplantation and results of treatment with recombinant human growth hormone Blood 1995 86: 825–831

    CAS  PubMed  Google Scholar 

  5. Wingard JR, Plotnick LP, Freemer CS et al. Growth in children after bone marrow transplantation: busulfan plus cyclophosphamide versus cyclophosphamide plus total body irradiation Blood 1992 79: 1068–1073

    CAS  PubMed  Google Scholar 

  6. Michel G, Socié G, Gebhard F et al. Late effects of allogeneic bone marrow transplantation for children with acute myeloblastic leukemia in first complete remission: the impact of conditioning regimen without total-body-irradiation – a report from the Societé Francaise de Greffe de Moelle J Clin Oncol 1997 16: 2238–2246

    Article  Google Scholar 

  7. Leahey AM, Teunissen H, Friedman DL et al. Late effects of chemotherapy compared to bone marrow transplantation in the treatment of paediatric acute myeloid leukaemia and myelodysplasia Med Pediatr Oncol 1999 32: 163–169

    Article  CAS  Google Scholar 

  8. Shaw PJ, Scharping C, Brian RJ et al. Busulfan pharmacokinetics using a single daily high-dose regimen in children with acute leukaemia Blood 1994 84: 2357–2362

    CAS  PubMed  Google Scholar 

  9. Goleta-Dy A, Dalla Pozza L, Shaw PJ et al. Acute myeloid leukaemia in Down's syndrome treated by bone marrow transplantation J Pediatr Child Health 1994 30: 275–277

    Article  CAS  Google Scholar 

  10. Shaw PJ, Afify Z . Rapid tapering of cyclosporin to maximise the graft-versus-leukaemia effect Bone Marrow Transplant 1999 23: 632–633

    Article  CAS  Google Scholar 

  11. Hamill PVV, Drizd TA, Johnson CL et al. NCHS growth curves for children from birth to 18 years: United States. DHEW Publ. No (PHS) 78–1650 Vital Health Stats 1977 165: 1–74

    Google Scholar 

  12. Tanner JM, Whitehouse RH . Clinical longitudinal standards for Ht, weight, Ht velocity, weight velocity, and stages of puberty Arch Dis Child 1976 51: 170–179

    Article  CAS  Google Scholar 

  13. Shankar SM, Bunin NJ, Moshang T . Growth in children undergoing bone marrow transplantation after busulfan and cyclophosphamide conditioning J Pediatr Hematol Oncol 1996 18: 362–366

    Article  CAS  Google Scholar 

  14. Alter CA, Thornton PS, Willi SM et al. Growth in children after bone marrow transplantation for acute myelogenous leukemia as compared to acute lymphocytic leukemia J Pediatr Endo Metab 1996 9: 51–57

    CAS  Google Scholar 

  15. De Simone M, Olioso P, Di Bartolomeo P et al. Growth and endocrine function following bone marrow transplantation for thalassemia Bone Marrow Transplant 1995 15: 227–233

    CAS  PubMed  Google Scholar 

  16. Guffon N, Souillet G, Maire I et al. Follow-up of nine patients with Hurler syndrome after bone marrow transplantation J Pediatr 1998 133: 119–125

    Article  CAS  Google Scholar 

  17. Boulad F, Bromley M, Black P et al. Thyroid dysfunction following bone marrow transplantation using hyperfractionated radiation Bone Marrow Transplant 1995 15: 71–76

    CAS  PubMed  Google Scholar 

  18. Mertens AC, Ramsay NKC, Kouris S, Neglia JP . Patterns of gonadal dysfunction following bone marrow transplantation Bone Marrow Transplant 1998 22: 345–350

    Article  CAS  Google Scholar 

  19. Thibaud E, Roriguez-Macias K, Trivin C et al. Ovarian function after bone marrow transplantation during childhood Bone Marrow Transplant 1998 21: 287–290

    Article  CAS  Google Scholar 

  20. Teinturier C, Hartmann O, Valteau-Couanet D et al. Ovarian function after autologous bone marrow transplantation in childhood: high-dose busulfan is a major cause of ovarian failure Bone Marrow Transplant 1998 22: 989–994

    Article  CAS  Google Scholar 

  21. Tiedemann K, Waters KD, Tauro GP et al. Results of intensive therapy in childhood acute myeloid leukaemia, incorporating high-dose melphalan and autologous bone marrow transplantation in first complete remission Blood 1993 82: 3730–3738

    CAS  PubMed  Google Scholar 

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Acknowledgements

Zeinab Afify was supported by the Leukaemia Research and Support Fund.

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Afify, Z., Shaw, P., Clavano-Harding, A. et al. Growth and endocrine function in children with acute myeloid leukaemia after bone marrow transplantation using busulfan/cyclophosphamide. Bone Marrow Transplant 25, 1087–1092 (2000). https://doi.org/10.1038/sj.bmt.1702384

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