Ha. Davies et al., DISPROPORTIONATE SHORT STATURE AFTER CRANIAL IRRADIATION AND COMBINATION CHEMOTHERAPY FOR LEUKEMIA, Archives of Disease in Childhood, 70(6), 1994, pp. 472-475
The effect of combination chemotherapy and cranial irradiation on fina
l height and body proportions was retrospectively examined in a cohort
of 142 children treated for acute lymphoblastic leukaemia (ALL). Eigh
ty four children (48 girls, 36 boys) received 24 Gy cranial irradiatio
n and 58 (35 girls, 23 boys) 18 Gy. None had received testicular or sp
inal irradiation. A significant reduction in standing height SD score
from diagnosis to final height was seen in all groups. Of the 109 chil
dren in whom sitting height measurements were available, 88 (81%) had
relatively shorter backs than legs and in 25 (23%) this disproportion
was of a marked degree. After mathematical correction for sitting heig
ht loss there was no longer a significant reduction in standing height
SD score at final height in all except the 24 Gy group of girls. Thes
e data suggest that disproportion is a common finding after treatment
for ALL and that, at least in some children, much if not all of the he
ight loss seen is due to a reduction in sitting height. Possible expla
nations for this disproportion include a disturbance of puberty or an
effect of chemotherapy on spinal growth, or both.