PUBERTAL GROWTH IN YOUNG-ADULT SURVIVORS OF CHILDHOOD LEUKEMIA

Purpose: To determine the effect of cranial irradiation (18 Gy and 24 Gy) on pubertal growth in young adult survivors of childhood acute lym phoblastic leukemia (ALL), Patients and Methods: Final height (FH) and pubertal growth were retrospectively examined in 142 young adult surv ivors of childhood ALL, All were in first remission and had received e ither 18 or 24 Gy of cranial irradiation, Eighty-four children (48 gir ls) were treated with 24 Gy and 58 (35 girls) with 18 Gy, None had rec eived either testicular or spinal irradiation, Timing and duration of puberty were studied in 110 patients, Results: Significant reduction i n height standard deviation score (SDS) from diagnosis to FH was seen in both sexes and in both dose groups, In girls, in both dose groups, mean age at peak height velocity (PHV) and mean age at menarche occurr ed significantly earlier than in the normal population. In boys, there was a normal timing of PHV, The amplitude of PHV wets significantly r educed in both sexes and in both dose groups, Parameters of pubertal d uration (PHV to menarche, PHV to FH, and menarche to FH) were not sign ificantly different from normal population values. Conclusion: In conc lusion, puberty occurred early in girls, but not in boys. Amplitude of PHV was reduced in both sexes, with no reduction in the duration of p uberty, It is likely that disturbances of both timing and quality of g rowth during puberty contribute to the loss of standing height and bod y disproportion seen in these children. (C) 1995 by American Society o f Clinical Oncology.