Korean J Hematol 2007; 42(4):
Published online December 30, 2007
https://doi.org/10.5045/kjh.2007.42.4.382
© The Korean Society of Hematology
박은영, 백희조, 한동균, 이순주, 조영국, 김영옥, 김찬종, 국훈, 우영종, 황태주
전남대학교 의과대학 소아과학교실, 화순전남대학교병원 조혈모세포이식센터
Background:
Growth impairment is a common complication after hematopoietic stem cell transplantation (SCT). The aim of this study was to evaluate the final adult height of patients who underwent SCT in childhood and to identify the factors that influence long-term growth in these patients.
Methods:
A retrospective review of 15 children who underwent SCT before puberty at Chonnam National University Hospital and reached final adult height was undertaken. To assess the severity of height reduction and to monitor the height changes longitudinally, height measurements of each patient both at the time of SCT and the final height were expressed as the height standard deviation score (SDS).
Results:
Seven children were males and eight were females with a median age of 12.8±2.4 years (range, 6.3∼14.7) at SCT. The median follow-up period was 7.1±2.0 years (range, 4.5∼11.1) and their final height was achieved at 18.1±1.5 years (range, 17.0∼21.8). Final height SDS values were within normal for the healthy population in all except two who had short stature (below -2.0 SDS). No patient achieved height values greater than +2.0 SDS. The final height SDS value (-0.5±1.2) was not decreased from the height SDS value at SCT (-0.8±0.8). The younger age group at SCT (6.1∼10.0 years, n=5) showed significantly lower final height SDS and greater ԤSDS than the older age group (10.1∼15.0 years, n=10) (-1.5± 0.6 vs. -0.1±1.1, P<.05; -1.2±0.7 vs. 0.5±0.8, P<.05, respectively). The irradiation-based conditioning (n=6) had negative effects on the ԤSDS (P>.05) and the final height SDS (P<.05). The gender, type of disease, donor type or the presence of chronic graft-versus-host disease did not influence height.
Conclusion:
Growth impairment may be encountered in children after SCT. A younger age at transplant and irradiation were found to be factors associated with reduced final height. However, most patients (13/15) reached a final adult height within normal limits for the general healthy population.
Keywords Stem cell transplantation, Fianl adult height, Growth impairment, Irradiation, Children
Korean J Hematol 2007; 42(4): 382-391
Published online December 30, 2007 https://doi.org/10.5045/kjh.2007.42.4.382
Copyright © The Korean Society of Hematology.
박은영, 백희조, 한동균, 이순주, 조영국, 김영옥, 김찬종, 국훈, 우영종, 황태주
전남대학교 의과대학 소아과학교실, 화순전남대학교병원 조혈모세포이식센터
Eun Young Park, Hee Jo Baek, Dong Kyun Han, Soon Ju Lee, Young Kuk Cho, Young Ok Kim, Chan Jong Kim, Hoon Kook, Young Jong Woo, Tai Ju Hwang
Blood and Marrow Transplantation Center,
Department of Pediatrics, Chonnam National University Hwasun Hospital,
Chonnam National University Medical School, Gwangju, Korea
Background:
Growth impairment is a common complication after hematopoietic stem cell transplantation (SCT). The aim of this study was to evaluate the final adult height of patients who underwent SCT in childhood and to identify the factors that influence long-term growth in these patients.
Methods:
A retrospective review of 15 children who underwent SCT before puberty at Chonnam National University Hospital and reached final adult height was undertaken. To assess the severity of height reduction and to monitor the height changes longitudinally, height measurements of each patient both at the time of SCT and the final height were expressed as the height standard deviation score (SDS).
Results:
Seven children were males and eight were females with a median age of 12.8±2.4 years (range, 6.3∼14.7) at SCT. The median follow-up period was 7.1±2.0 years (range, 4.5∼11.1) and their final height was achieved at 18.1±1.5 years (range, 17.0∼21.8). Final height SDS values were within normal for the healthy population in all except two who had short stature (below -2.0 SDS). No patient achieved height values greater than +2.0 SDS. The final height SDS value (-0.5±1.2) was not decreased from the height SDS value at SCT (-0.8±0.8). The younger age group at SCT (6.1∼10.0 years, n=5) showed significantly lower final height SDS and greater ԤSDS than the older age group (10.1∼15.0 years, n=10) (-1.5± 0.6 vs. -0.1±1.1, P<.05; -1.2±0.7 vs. 0.5±0.8, P<.05, respectively). The irradiation-based conditioning (n=6) had negative effects on the ԤSDS (P>.05) and the final height SDS (P<.05). The gender, type of disease, donor type or the presence of chronic graft-versus-host disease did not influence height.
Conclusion:
Growth impairment may be encountered in children after SCT. A younger age at transplant and irradiation were found to be factors associated with reduced final height. However, most patients (13/15) reached a final adult height within normal limits for the general healthy population.
Keywords: Stem cell transplantation, Fianl adult height, Growth impairment, Irradiation, Children
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