Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
2
pubmed:dateCreated
1995-8-15
pubmed:abstractText
Seventy-six prepubertal children receiving autologous or allogeneic bone marrow transplantation (BMT) were enrolled in a prospective study on the impact of different pretransplant preparative regimens on growth. Patients were divided into three groups: group I, consisting of 37 children who had received total body irradiation (TBI) and cytotoxic drugs as preparative regimen; group II, including 17 children receiving prophylactic cranial irradiation before being conditioned with TBI and cytotoxic drugs; and group III, composed of 22 patients transplanted after a busulfan (BU)-containing myeloablative therapy. All patients have a minimum follow-up of 2 years, whereas 48 and 34 patients have been studied until 3 and 4 years after transplant, respectively. Height and growth rate were expressed as standard deviation score (SDS). Growth hormone (GH) secretion in response to pharmacologic stimuli was evaluated after documented growth failure. Patients with GH deficiency were treated with recombinant human GH, and response to therapy was evaluated. The main impairment of growth rate in patients belonging to group II was observed in the first year after TBI (growth rate SDS changing from -0.12 +/- 0.23 to -1.23 +/- 0.25, P < .005), with only a slight loss in the following years, whereas in group I children growth failure occurred in the third year after TBI (-1.36 +/- 0.28 SDS in comparison to a pre-BMT SDS of 0.10 +/- 0.15, P < .005). Therefore, growth velocity between these two groups differed significantly in the first 2 years (P < .01) but subsequently equalized. On the contrary, all BU-treated children but 2 grew normally. GH deficiency was shown in the vast majority of children with growth impairment. Twenty-three children treated with recombinant human GH are evaluable; a successful response was observed in all but 1, with the mean growth rate increasing from -2.29 +/- 0.27 before treatment to 0.86 +/- 0.38 and to 1.66 +/- 0.56 SDS at 1 and 2 years after treatment, respectively (P < .001). In conclusion, growth rate impairment was common in patients receiving TBI, with the speed of onset of both decreased growth velocity and GH deficiency depending mainly on the total dose of radiation. On the contrary, patients receiving BU did not experience significant problems in terms of growth velocity. The timely start of appropriate hormonal replacement therapy may ameliorate the final growth of children undergoing BMT.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
AIM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:month
Jul
pubmed:issn
0006-4971
pubmed:author
pubmed:issnType
Print
pubmed:day
15
pubmed:volume
86
pubmed:owner
NLM
pubmed:authorsComplete
N
pubmed:pagination
825-31
pubmed:dateRevised
2006-11-15
pubmed:meshHeading
pubmed-meshheading:7606014-Antineoplastic Combined Chemotherapy Protocols, pubmed-meshheading:7606014-Body Height, pubmed-meshheading:7606014-Bone Marrow Transplantation, pubmed-meshheading:7606014-Busulfan, pubmed-meshheading:7606014-Child, pubmed-meshheading:7606014-Child, Preschool, pubmed-meshheading:7606014-Combined Modality Therapy, pubmed-meshheading:7606014-Dwarfism, Pituitary, pubmed-meshheading:7606014-Female, pubmed-meshheading:7606014-Genetic Diseases, Inborn, pubmed-meshheading:7606014-Growth Disorders, pubmed-meshheading:7606014-Growth Hormone, pubmed-meshheading:7606014-Humans, pubmed-meshheading:7606014-Infant, pubmed-meshheading:7606014-Male, pubmed-meshheading:7606014-Neuroblastoma, pubmed-meshheading:7606014-Pituitary Gland, Anterior, pubmed-meshheading:7606014-Puberty, pubmed-meshheading:7606014-Radiation Injuries, pubmed-meshheading:7606014-Recombinant Proteins, pubmed-meshheading:7606014-Treatment Outcome, pubmed-meshheading:7606014-Whole-Body Irradiation
pubmed:year
1995
pubmed:articleTitle
Role of busulfan and total body irradiation on growth of prepubertal children receiving bone marrow transplantation and results of treatment with recombinant human growth hormone.
pubmed:affiliation
Department of Pediatrics, University of Pavia, IRCCS Policlinico San Matteo, Italy.
pubmed:publicationType
Journal Article, Comparative Study