GROWTH IN PATIENTS AFTER ALLOGENEIC BONE-MARROW TRANSPLANT FOR HEMATOLOGICAL DISEASES IN CHILDHOOD

The growth of 66 long-term survivors, transplanted in two centres (Gen oa S.Martino and Monza) is reported, Patients were all under age 15 at the time of bone marrow transplantation (mean 9.8 +/- 3.4 years; rang e 1.07-15 years) with a minimum follow-up of at least 12 months, They were divided into four groups, Group 1: eight patients with severe apl astic anemia (SAA); conditioning included cyclophosphamide (CY) 200 mg /kg only, Group 2:32 patients with acute lymphoblastic leukemia (ALL), and acute myeloid leukemia (AML); conditioning included CY 120 mg/kg and 10-12 Gy fractionated total body irradiation (fTBI), Group 3:20 pa tients with ALL who had previously received cranial irradiation; condi tioning included CY 120 mg/kg and fTBI with an additional testicular i rradiation (4 Gy), Group 4: six patients with chronic myeloid leukemia (CML) and AML; conditioning included CY 200 mg/kg and busulfan (BU) 1 6 mg/kg, Growth was impaired in all four groups, including the unirrad iated groups (-0.2 +/- 0.7 and -0.5 +/- 0.6 delta-SDS in groups 1 and 4, respectively), Growth impairment-SDS was statistically significant in the two irradiated groups (-0.7 +/- 1.0 and -0.9 +/- 1.0 delta-SDS in groups 2 and 3, respectively), more marked in patients who had had previous cranial irradiation, Chronic graft-versus-host disease and it s treatment were not found to have a major effect on growth.