GH Treatment in Children in Remission from Leukaemia and Lymphoma in KIGS Nikolaus Stahnke KIGS 10 Year Book, 1999

GH Treatment in Children in Remissionfrom Leukaemia and Lymphoma in KIGS

Nikolaus Stahnke

KIGS 10 Year Book, 1999

N Stahnke - KIGS 10 Year Book, 1999

Treatment groups of patients treated foracute lymphoblastic leukaemia (ALL)

TBI, total body irradiation

Treatment Patients(n)

Cranial irradiation 115

Cranial irradiation + TBI 40

Craniospinal irradiation 40

Craniospinal irradiation + TBI 24

TBI only 21

Therapy unknown 24

Chemotherapy only 8

Total: 272


Characteristics of patients with acutelymphoblastic leukaemia (ALL)

ALL, acute lymphoblastic leukaemia; TBI, total body irradiation; MPH, mid-parental height; SH, sitting height; LL, leg length; BMI body mass index

All patients Cranialirradiation

Cranialirradiation +

TBI

Craniospinalirradiation

Percentile(n) (median) (10

th) (90

th) (n) (median) (n) (median) (n) (median)

Age at start of GH (yrs) 272 11.8 8.3 14.8 115 11.9 40 11.3 40 11.6

Time elapsed sincediagnosis of ALL (yrs)

253 7.5 4.3 10.8 115 8.1 40 6.6 39 7.9

Bone age (yrs) 134 11.2 6.3 14.0 59 11.0 17 11.0 22 11.6

MPH (SDS) 249 0.0 -1.5 1.3 108 -0.1 38 0.2 36 -0.2

Height (SDS) 272 -1.5 -2.6 -0.2 115 -1.5 40 -1.4 40 -1.7

Height – MPH (SDS) 249 -1.5 -3.0 0.0 108 -1.2 38 -1.8 36 -1.5

SH (SDS) 103 -1.8 -3.4 0.2 51 -1.6 17 -1.9 15 -2.4

LL (SDS) 103 -0.7 -1.9 0.7 51 -0.4 17 -0.9 15 -0.8

SH SDS – LL SDS 103 -1.0 -2.8 0.5 51 -0.9 17 -1.4 15 -1.1

Height velocity (cm/yr) 168 3.9 2.1 6.2 75 4.4 25 3.0 23 4.3

BMI (SDS) 271 0.4 -1.1 1.8 114 0.4 40 0.6 40 0.6


Growth response in KIGS patients with acute lymphoblastic leukaemia (ALL) during the first year of GH treatment compared with first-year

height velocity predicted for children with idiopathic GHD

Predicted height velocity for the first treatment year (cm/year)

Stu

de

nti

se

d r

es

i du

al s


Height velocity of patients who underwent cranial irradiation, cranial irradiation plus total body body irradiation and craniospinal irradtion for

leukaemia and subsequent GH therapy

Cranial irradiation ( ), cranial irradiation plus total body irradiation (TBI) ( ) and craniospinal irradiation ( )

8

7

6

5

4

0 1 2 3 4

He

igh

t v

elo

cit

y (

cm

/ye

ar)

Duration of therapy (years)

X + SE


Patients with acute lymphoblastic leukaemia (ALL)at the end of GH treatment

TBI, total body irradiation; MPH, mid-parental height; SH, sitting height; LL, leg length; BMI, body mass index

All patients Cranialirradiation

Cranialirradiation +

TBI

Craniospinalirradiation

Percentile(n) (median) (10th) (90th) (n) (median) (n) (median) (n) (median)

Age at start of GH (yrs) 103 16.4 13.9 18.3 48 16.2 16 16.8 16 16.5

Bone age (yrs) 27 15.9 13.5 17.0 15 15.9 3 16.1 6 15.3

Height (SDS) 103 -1.1 -2.9 0.3 48 -0.8 16 -1.5 16 -1.3Height (SDS) 103 0.4 -0.5 1.6 48 0.6 16 0.1 16 0.4

Height – MPH (SDS) 96 -1.3 -2.7 0.2 45 -0.9 16 -2.0 15 -1.3

SH (SDS) 48 -1.8 -3.5 -0.1 25 -1.8 10 -1.8 4 -0.9

LL (SDS) 48 -0.5 -2.2 1.1 25 -0.4 10 -0.9 4 -0.1

SH SDS – LL SDS 48 -1.2 -3.1 0.5 25 -1.0 10 -1.0 4 -1.4

BMI (SDS) 101 0.1 -1.7 1.7 47 0.2 16 0.5 16 0.6

Duration of GH (yrs) 103 3.6 1.6 6.0 48 3.5 16 3.7 16 3.1


Response to GH treatment of the total group of acute lymphoblastic leukaemia (ALL) patients, patients treated with cranial irradiation

and with craniospinal irradiation

0, prior to start of GH therapy; FH, end of GH therapy; HT, height; MPH, mid-parental height; , difference; SH, sitting height; LL, leg length

He

igh

t (S

DS

)

ALL:Total group

ALL:Cranial irradiation

ALL:Craniospinal irrad

HT

HT

-MP

H

SH

-LL

HT

HT

-MP

H

SH

-LL

HT

HT

-MP

H

SH

-LL


Characteristics at start of GH treatment of patients with acute myeloid leukaemia and non-Hodgkin lymphoma

MPH, mid-parental height; SH, sitting height; LL, leg length; BMI body mass index

Acute myeloid leukaemia Non-Hodgkin lymphoma

Percentile Percentile(n) (median) (10

th) (90

th) (n) (median) (10

th) (90

th)

Age at start of GH (yrs) 42 11.7 8.1 14.2 18 11.7 7.5 15.8

Time elapsed since diagnosis (yrs) 38 5.4 2.9 8.3 18 5.8 2.2 9.8

Bone age (yrs) 19 11.0 6.5 15.3 10 12.3 6.5 14.1

MPH (SDS) 39 0.0 -1.6 1.7 17 -0.3 -1.0 1.0

Height (SDS) 42 -1.6 -2.9 -0.2 18 -2.0 -2.8 -0.5

Height – MPH (SDS 39 -1.4 -3.5 0.0 17 -1.9 -3.1 -0.4

SH (SDS) 16 -1.7 -3.9 -0.4 3 -2.6 -3.1 -2.6

LL (SDS) 16 -0.5 -1.4 0.7 3 -2.0 -3.1 -1.2

SH SDS – LL SDS 16 -1.5 -2.9 0.1 3 -0.6 -1.4 0.0

Height velocity (cm/yr) 19 3.4 2.4 4.4 10 4.2 1.1 7.1

Height velocity (SDS) 19 -2.9 -5.0 -1.8 10 -1.9 -5.5 2.2

BMI (SDS) 42 -0.2 -1.5 0.8 13 0.5 -2.4 2.3


Height velocity (cm/year and SDS for chronological age) and height SDS for chronological age in patients with acute acute myeloid leukaemia and non-Hodgkin lymphoma receiving GH treatment

AML ( ), NHL ( )

Duration of therapy (years)

He

igh

t v

elo

cit

y f

or

ch

ron

olo

gic

al

ag

e (

SD

S)

He

igh

t fo

r c

hro

no

log

ica

l a

ge

(S

DS

)H

eig

ht

ve

loc

ity

(c

m/y

ea

r)8

6

4

2

+3

+1 0 -1

-3

0-0.8

-1.2

-1.6

-2.0

0 1 2 3 4


Characteristics of patients with acute myeloid leukaemiaand non-Hodgkin lymphoma at the end of GH treatment

Acute myeloid leukaemia Non-Hodgkin lymphoma

Percentile Percentile(n) (median) (10th) (90th) (n) (median) (10th) (90th)

Age at start of GH (yrs) 22 16.0 14.3 17.1 6 17.3 14.3 18.8

Height (SDS) 22 -1.3 -3.4 0.3 6 -1.1 -3.5 0.3

Height (SDS) 22 0.2 -0.7 0.8 6 0.9 -0.8 2.3

MPH (SDS) 21 -1.2 -3.8 0.2 6 -1.4 -3.1 -0.3

BMI (SDS) 22 -0.6 -2.3 1.1 6 0.4 -4.2 2.0

Duration of GH (yrs) 22 3.0 1.7 5.6 6 3.2 1.9 6.3

Documents

GH Treatment in Children in Remission from Leukaemia and Lymphoma in KIGS Nikolaus Stahnke KIGS 10 Year Book, 1999