CLINICAL CHARACTERISTICS AND FACTORS AFFECTING GROWTH IN LONG-TERM SURVIVORS OF CANCER

We evaluated clinical characteristics and growth in 51 (24 males) long -term survivors of childhood cancer (median follow up 12.7 years). Pat ients were shorter, had a higher proportion of body fat and higher sys tolic blood pressure than their controls. The change in relative heigh t during treatment was -0.83 standard deviation score (S.D.S.) in pati ents with cranial irradiation and -0.32 S.D.S. in patients without cra nial irradiation; the figures after treatment were -0.56 and 0.20 S.D. S., respectively. Half (r(2) = 0.50) of the variation in growth retard ation during therapy could be explained by the cumulative doses of 6-m ercaptopurine (6-MP) and vincristine and relative height at diagnosis. Cranial irradiation, increased relative height at diagnosis and young age at diagnosis were significant predictors of growth failure over t he total observation period, explaining 43% of the variation. We concl ude that long-term survivors of childhood cancer have impaired linear growth, increased body fat mass and elevated systolic blood pressure. Young children who are tall for their age at diagnosis and treated wit h cranial irradiation have the highest risk of impaired growth after t he diagnosis. High doses of 6-MP seem to contribute significantly to g rowth retardation during therapy. (C) 1996 Wiley-Liss, Inc.