Effect on growth parameters of bone marrow transplantation with a chemotherapy-only conditioning regimen

INTRODUCTION

The increasing use of bone marrow transplantation (BMT) has increased survival among a growing number of children and young adults afflicted by malignant and nonmalignant hematologic disorders. Accordingly, quality of life has emerged as an important issue. Because they are a concern in this group, we assessed growth and development, following chemotherapy-only conditioning regimens.

MATERIALS AND METHODS

Twelve prepubertal children (8 boys, G(1)P(1) and 4 girls, B(1)P(1)) with a mean age of 6 +/- 2 years (age range: 3.5 to 10 years) before and at 3, 6, 9, and 12 months post-BMT.

RESULTS

Growth velocity at 1 year posttransplant was 10.0 +/- 3.5 cm/y. One year post-BMT, the statistical deviation saturation for growth velocity was 4.31 +/- 4.21. Height standard deviation score was -1.4 +/- 1.2 before and -0.5 +/- 1.3 1 year post-BMT (P <.004). The average weight of our subjects was 20 +/- 6 kg before and 26 +/- 9.5 kg 1 year post-BMT.

DISCUSSION

BMT with a chemotherapy-only conditioning regimen not only does not disturb growth in children; it is actually associated with a relative growth spurt afterward.

Thyroid, parathyroid, gonadal, and pancreatic β-cell function after bone marrow transplantation with chemotherapy-only conditioning

INTRODUCTION

Radiation and cytotoxic chemotherapy can provoke short- and long-term endocrine dysfunction. We studied the prevalence of thyroid, parathyroid, gonadal, and pancreatic beta-cell function in patients undergoing bone marrow transplantation (BMT).

MATERIALS AND METHOD

Forty-six patients (12 women, 34 men), aged 1.5 to 49 years (mean, 15.1 years), were evaluated for thyroid, parathyroid, gonadal, and pancreatic beta-cell function before and 3, 6, and 12 months after BMT with a little busulfan-cyclophosphamide conditioning regimen.

RESULTS

Thyroid and parathyroid function was unaltered by BMT. Leydig cell function was normal in 11 adult men (G5P5) before and at 3, 6, and 12 months after BMT, but injury to the germinal epithelium (oligo- or azoospermia) was seen before and 12 months after BMT. There was no relationship between serum FSH and germinal epithelial injury. Maturation was normal in six boys (G2P2 or G3P3 at BMT) 12 months post-BMT. Primary hypogonadism was seen in four adult women (B5P5) after BMT. One 14-year-old girl continued to have regular menstrual periods during the 24 months after BMT. Another girl (P1B1 pre-BMT) developed ovarian failure 12 months post-BMT. Pancreatic beta-cell function was normal pre- and post-BMT in 12 thalassemic patients with serum ferritin > 1000 ng/mL.

CONCLUSION

BMT with chemotherapy-only conditioning seems primarily to affect gonadal function, without having any significant effect on thyroid, parathyroid, or pancreatic beta-cell function.