Height and weight pattern up to 20 years after treatment for acute lymphoblastic leukaemia

OBJECTIVE—To assessheight and body mass index standard deviation scores up to 20 yearsafter treatment for acute lymphoblastic leukaemia (ALL).
SUBJECTS ANDMETHODS—Height and body mass index standarddeviation scores were measured in 33 patients (14 boys and 19 girls)with childhood ALL at diagnosis, after the end of treatment, at finalheight, and at follow up 10-20 years (median, 16.2) after diagnosis.Eleven patients were treated with chemotherapy only and 22 patientswere treated with chemotherapy and cranial irradiation.
RESULTS—In thechemotherapy only group, height standard deviation scores were the sameat follow up as at diagnosis, but there was a significant decrease inheight standard deviation scores during treatment. Mean body mass indexstandard deviation scores increased steadily from the start oftreatment until final height and continued to increase from finalheight until follow up. In the cranially irradiated group, mean heightstandard deviation scores decreased steadily from the start oftreatment until follow up. Mean body mass index standard deviationscores increased continuously from the start of treatment until finalheight and from final height until follow up.
CONCLUSION—Chemotherapycombined with cranial irradiation and chemotherapy alone might bepersisting risk factors for obesity even after final height has beenattained in patients treated for childhood ALL. Chemotherapy is a riskfactor for reduced final height only when administered in combinationwith cranial irradiation. These problems need to be recognised anddealt with at follow up examination.