Final height of patients who underwent bone marrow transplantation for hematological disorders during childhood: A study by the working party for late effects-EBMT

Few data are available on the long-term effect of bone marrow transplantati on (BMT) on growth. This study examines those factors that play a role in t he final height outcome of patients who underwent BMT during childhood. Dat a on 181 of 230 patients with aplastic anemia, leukemias, and lymphomas who had BMT before puberty (mean age, 9.8 +/- 2.6 years) and who had reached t heir final height were analyzed. An overall decrease in final height standa rd deviation score (SDS) value was found compared with the height at BMT (P < 10(7)) and with the genetic height (P < 10(7)). Girls did better than bo ys, and the younger in age the person was at time of BMT, the greater the l oss in height. Previous cranial irradiation + single-dose total body irradi ation (TBI) caused the greatest negative effect on final height achievement (P < 10(4)). Fractionation of TBI reduces this effect significantly and co nditioning with busulfan and cyclophosphamide seems to eliminate it. The ty pe of transplantation, graft-versus-host disease, growth hormone, or steroi d treatment did not influence final height. Irradiation, male gender and yo ung age at BMT were found to be major factors for long-term height loss. Ne vertheless, the majority of patients (140/181) have reached adult height wi thin the normal range of the general population. (C) 1999 by The American S ociety of Hematology.