Nine patients developed osteochondromata, a mean of 6 years after total bod
y irradiation (TBI) given before bone marrow transplantation for childhood
leukaemia. This represents 23% of patients receiving TBI during the period
from 1981 to 1989 surviving greater than or equal to 5 years after bone mar
row transplantation. The patients were followed up for a mean of 12.5 years
from diagnosis of leukaemia and a mean of 2.5 years from diagnosis of oste
ochondromata. No osteochondroma, including three lesions removed surgically
, showed evidence of malignant change. Six patients received growth hormone
for irradiation-induced growth hormone deficiency, but this did not appear
to influence the natural history of the osteochondromata. Radiation-induce
d osteochondromata (RIO) are often multiple and ore indistinguishable from
the: more common idiopathic type. The incidence of RIO after TBI was higher
than that reported after local irradiation.