FINAL HEIGHT AND HORMONAL FUNCTION AFTER BONE-MARROW TRANSPLANTATION IN CHILDREN

Aim: To analyze final height and hormonal function in long-term surviv ors of bone marrow transplantation (BMT). Patients: Group 1 consisted of 16 patients (10 boys) with a hematologic malignancy, mostly leukemi a, conditioned for BMT with total body irradiation (TBI), 7.5 to 12 Gy , and cyclophosphamide. Group 2 consisted of 14 patients (9 boys) with severe aplastic anemia, conditioned with chemotherapy only. Results: In group 1, patients achieved a reduced final height after BMT, The di fference between the height standard deviation score (SDS) at BMT and the height SDS at final height was -1.96 (0.82) SDS in boys and -0.92 (0.71) SDS in girls (p = 0.0001, and p = 0.02 respectively). Final hei ght was also lower than target height (boys, p = 0.01; girls, p = 0.03 ). Prepubertal growth in the first 3 years after BMT was normal but pu bertal height gain was decreased. The patients in group 2 achieved nor mal height. Thyroid function and adrenal function were normal in all p atients, and no growth hormone deficiency was detected. Serum follicle -stimulating hormone values after BMT were increased in all group 1 pa tients, with return to normal in two patients. Serum luteinizing hormo ne values were increased in all group 1 girls, with recovery in one gi rl. Normal serum luteinizing hormone values and spontaneous puberty we re found in all group 1 boys. In group 2, disturbances in gonadotropin s were seen only in three boys and two girls. Conclusion: In patients treated in childhood with BMT after chemotherapy and TBI with 7.5 Gy o r more, final height is compromised because of blunted growth in puber ty. Patients who had not received TBI suffered no height loss. In the majority of patients, the combination of chemotherapy and TBI also res ulted in irreversible disturbances of gonadal function.