GROWTH, GROWTH-HORMONE AND FINAL HEIGHT AFTER BMT - POSSIBLE RECOVERYOF IRRADIATION-INDUCED GROWTH-HORMONE INSUFFICIENCY

The aim of the present study was to assess grwoth, final height, growt h hormone (GH) secretion and growth factors after BMT including TBI in childhood, The median age of the 25 participants was 11.3 years at BM T, and a median of 7.5 years had elapsed since BMT, The median height standard deviation score (SDS) declined significantly from diagnosis u ntil 4 years after BMT (it = 25, P = 0.015), and decreased 1.08 SDS fr om diagnosis until final height (n = 14, P = 0.030), Sitting height to standing height ratio was impaired, -0.64 SDS, P < 0.05, GH insuffici ency was found in 32% at follow-up, Repeated assessments of GH product ion over the years indicated improvement in GH secretion in nine indiv iduals, Evaluation of spontaneous 24-h GH secretion indicated a secret ory pattern similar to controls, although the total amount of GH secre ted was lower, Neither insulinlike growth factor-1 (IGF-1) nor IGF bin ding protein-3 (IGFBP-3) alone could be used as a marker of GH insuffi ciency, IGF-1 was low: -1.18 SDS; (P < 0.001), In conclusion, our stud y demonstrated the impact on growth, final height, body proportions, G H secretion and growth factors after BMT including TBI, We hypothesize that children who receive BMT ata younger age are more at risk of los s of final height and abnormal body proportions, Our data indicate tha t some improvement in GH production may occur over the years.