Growth and pubertal assessment after treatment in acute leukemia.

To evaluate the effect of leukaemia and its treatment on growth and puberty, we studied retrospectively the serial heights and pubertal development of 37 children with acute leukaemia. The age of diagnosis ranged from 10 months to 13 years, with a duration of follow-up varying from 2 years to 14 years. The SDS (Z score) which reflects the deviation of height measurements from the population mean was used to assess height change at yearly intervals. Pubertal assessment was also made using the Tanner standards. 25 (69%) children showed a falling trend in mean Z scores over a 5 year follow-up period. The difference between the mean Z scores at 0 and 5 years was statistically significant (p < 0.035). However, there was no significant correlation between age of onset of disease and duration of survival with the deviation in the Z score. 11 children did not demonstrate a fall in the Z scores. There were, however, no defined factors such as age of onset, duration of follow-up, and sex distribution which could predict growth failure. Pubertal assessment showed normal development in all children with the pubertal age group (n = 11), except for 3 boys, two of whom had received testicular irradiation.     

Long term endocrine complications of acute leukemia therapy--a case report.

We report a patient with acute lymphoblastic leukemia who underwent treatment comprising chemotherapy, radiotherapy (cranial and testicular) and then a bone marrow transplant from an identical twin. He was cured of his leukemia and has been disease-free for nine years. With long term survival, there were problems, notably those of growth and endocrine insufficiency, which needed special considerations in management.     

Cocaine use in pregnancy in Amsterdam

To study the effects of cocaine use in pregnancy in Amsterdam, clinical data on cocaine-using pregnant women ( n = 21) and their offspring ( n = 23) were obtained retrospectively (1987–1994) at the Academic Medical Center, Amsterdam. Infants exposed to cocaine had a median gestational age of 39 weeks and a median birth weight of 3090 g. There were six preterm infants, two small-for-gestational-age infants and five infants with a small head circumference. Three infants had a congenital malformation. One infant (Potter's syndrome) died shortly before birth. One infant had congenital syphilis, four had intracerebral abnormalities on ultrasound and four had abnormal neurologic symptoms in the neonatal period. One infant died after 21 days of life. At follow-up four infants showed abnormal development. In 12 of the 23 infants (52%), one or more possible effects of cocaine were found.