Final height of patients who underwent stem cell transplantation in childhood

Final height was analyzed in sixty patients (35: male, 25: female) who underwent stem cell transplantation (SCT) during childhood between 1983 and 1998. The median age at transplant was 11 years 3 months. Median follow up period after stem cell transplantation was 13 years (range 5 years 5 months to 19 years 9 months). These patients included 37 with acute leukemia, 12 with severe aplastic anemia, 7 with malignant lymphoma, 2 with neuroblastoma and 2 with chronic myeloid leukemia. Irradiation during conditioning regimen included total body irradiation (TBI) in 36 patients, and total lymphoid irradiation (TLI) in 9 patients. The remaining 15 patients were not irradiated. Nine out of 25 patients with acute lymphoblastic leukemia received cranial radiation therapy (conformal radiotherapy (CRT), 18-24 Gy). Seven of them were conditioned with TBI. Three children were treated with recombinant human growth hormone, and 18 patients (5: male, 13: female) received sex hormone replacement therapy. The difference between height standard deviation score (SDS) at SCT and that of the final height was calculated and was defined as ΔSDS. Patients conditioned with TBI showed significantly greater reduction in height SDS compared to those conditioned with TLI (p=0.002) or non-irradiated patients (p=0.0007). Patients who received TBI before the age of 6 showed significantly greater loss of final height compared to the older age groups. History of CRT prior to SCT did not influence ΔSDS (p=0.39). By a multivariate analysis male gender, an age under 6 years at SCT and TBI were found to be major factors for long-term height loss. (author)