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.