Abstract
TBI preparing to BMT is frequently followed by growth retardation. As GH deficiency (GHD) is a well known complication of cranial irradiation, the purpose of this study was to evaluate the risk of GHD after TBI and its possible relationship to this failure of growth. 20 children received BMT for ALL (n= 8), immunodeficiency (n= 6) or other disease (n= 6). 15 of them (group I) had TBI at 9-12 Gy doses after conditioning by chemotherapy. They were compared to 5 children (group II) who had only chemotherapy. None of the children received additional cranial irradiation. Results were as follcws (median - range) :
Growth retardation was significantly superior in group I than in group II (p<0.05). In group I, out of 5 patients with growth failure (>1SD) one had GHD and the 4 others had normal GH secretion as shown by plasma Sm-C and 12 hr GH nocturnal profile. No significant growth retardation occured in group II. Elevated TSH was found in 5 cases of group I with T4 normal (3) or moderatly decreased (2).
In conclusion, after a mean interval time of 3.5 yr GHD does not appear as a major complication of TBI. Thyroid deficiency is more frequent. Growth retardation often severe, is probably more frequently the consequence of the cartilage irradiation. A more prolonged follow-up of these patients is still necessary.
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Fontoura, M., Brauner, R., Rappaport, R. et al. GROWTH AND ENDOCRINE FUNCTION AFTER BONE MARROW TRANSPLANTATION (BMT) WITH OR WITHOUT TOTAL BODY IRRADIATION (TBI). Pediatr Res 23, 111 (1988). https://doi.org/10.1203/00006450-198801000-00062
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DOI: https://doi.org/10.1203/00006450-198801000-00062
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