Contributions
Abstract: PB1649
Type: Publication Only
Background
Over the past four decades treatment of childhood acute lymphoblastic leukemia has been modified with the aim of achieving high survival rate while reducing the risk of the life threatening late-effects and promoting risk-based follow-up care of survivors.
Aims
The aim of our study is evaluation of late effects of chemotherapy and cranial radiotherapy on the endocrine system in children with acute lymphoblastic leukemia.
Methods
Fourty-eight patients, who were diagnosed and treated for ALL between 1997-2007 in Istanbul Kanuni Sultan Suleyman Education and Research Hospital Pediatric Hematology-Oncology Clinic and have disease-freee for at least 5 years after cessation of treatment, were evaluated prospectively. The study form included each patients age, gender, weight, height, target height, parental height, treatment protocol, stage of puberty, bone age, TSH, free T4, LH, FSH, estradiol or testosterone, IGF-1 and IGFBP-3 levels. Annual rate of growth was evaluated for each patient. The patients with inadequate growth rate and delayed bone age were subjected to growth hormon stimulation test with clonidine.
Results
Mean age of the patients was 14.41±2.85 (10.5-22.4) years. Thirty-one of patients had prophylactic cranial radiotherapy; five of them 18 Gy and twenty-six had 12 Gy CRT. Fifteen of the 48 patients were diagnosed with at least one endocrinological disorder. Six patients had lower height (<-2 SD), three patients had a body mass index >30kg/m². Bone age delayed in two patients. Four patients had IGF-1 value below <-2SD and two patients had inadequate levels of growth hormone. Tanner stage of the patients were appropiate for their ages except for one patient with hypergonadotropic hipogonadism and one patient with pubertas precox. Subclinical hypotiroidism was detected in two patients.
Conclusion
Significant late effects may develop over time in children treated for ALL. For this reason long-term follow-up of these children is necessary. Because of the awareness of the late effects can the treatment modifed to reducing of the late effects.
Session topic: 2. Acute lymphoblastic leukemia - Clinical
Keyword(s): Radiotherapy, Late effects, chemotherapy, Acute lymphoblastic leukemia
Abstract: PB1649
Type: Publication Only
Background
Over the past four decades treatment of childhood acute lymphoblastic leukemia has been modified with the aim of achieving high survival rate while reducing the risk of the life threatening late-effects and promoting risk-based follow-up care of survivors.
Aims
The aim of our study is evaluation of late effects of chemotherapy and cranial radiotherapy on the endocrine system in children with acute lymphoblastic leukemia.
Methods
Fourty-eight patients, who were diagnosed and treated for ALL between 1997-2007 in Istanbul Kanuni Sultan Suleyman Education and Research Hospital Pediatric Hematology-Oncology Clinic and have disease-freee for at least 5 years after cessation of treatment, were evaluated prospectively. The study form included each patients age, gender, weight, height, target height, parental height, treatment protocol, stage of puberty, bone age, TSH, free T4, LH, FSH, estradiol or testosterone, IGF-1 and IGFBP-3 levels. Annual rate of growth was evaluated for each patient. The patients with inadequate growth rate and delayed bone age were subjected to growth hormon stimulation test with clonidine.
Results
Mean age of the patients was 14.41±2.85 (10.5-22.4) years. Thirty-one of patients had prophylactic cranial radiotherapy; five of them 18 Gy and twenty-six had 12 Gy CRT. Fifteen of the 48 patients were diagnosed with at least one endocrinological disorder. Six patients had lower height (<-2 SD), three patients had a body mass index >30kg/m². Bone age delayed in two patients. Four patients had IGF-1 value below <-2SD and two patients had inadequate levels of growth hormone. Tanner stage of the patients were appropiate for their ages except for one patient with hypergonadotropic hipogonadism and one patient with pubertas precox. Subclinical hypotiroidism was detected in two patients.
Conclusion
Significant late effects may develop over time in children treated for ALL. For this reason long-term follow-up of these children is necessary. Because of the awareness of the late effects can the treatment modifed to reducing of the late effects.
Session topic: 2. Acute lymphoblastic leukemia - Clinical
Keyword(s): Radiotherapy, Late effects, chemotherapy, Acute lymphoblastic leukemia