Treatment regimens for acute lymphoblastic leukemia in the 1970s and 1980s are associated with adult short stature today

Article Outline

• Copyright

The cross-sectional study reported by Chow et al of adult height of 2,434 survivors of childhood acute lymphoblastic leukemia (ALL) compared with their siblings provides several sound conclusions about treatments in the 1970s and 1980s, as well as worthy hypotheses for testing of current treatments. The investigators report decreased adult height and increased risk of short stature in cancer survivors, with graded adverse effects for diagnosis prior to puberty, increasing doses of cranial radiotherapy, and radiotherapy of any dosage to the spine. The study provides evidence that there was no “catch-up” growth post treatment.

Doses of radiation in protocols for treatment of ALL since this cohort was treated have been reduced or eliminated, but have been replaced by more aggressive chemotherapy regimens. Because even the “milder” chemotherapy circa 1970-1986, without radiation therapy, was associated with decreased adult height in the current report of Chow et al, there is reasonable concern for adverse long-term growth effect of protocols circa 2000s.

• 
  • View Large Image
  • Download to PowerPoint