Final Adult Height of Children with Normal Endocrine Function after Hematopoietic Stem Cell Transplantation

Lee, Dae Hyoung; Lee, Ju Young; Kwon, Young Joo; Jung, Min Ho; Cho, Bin; Kim, Hack Ki; Lee, Byung Churl

Abstract

PURPOSE: We analyzed the final adult height of patients without endocrine dysfunction who underwent hematopoietic stem cell transplantation (HSCT) during the childhood.
METHODS
We evaluated the final height of 28 long term survivors (13 males, 15 females) who underwent HSCT at the mean age of 12.3 years. Patients who had solid tumors, inherited diseases and endocrine dysfunction before or after HSCT were excluded. The mean age at last visit was 18.8 years. Height values were expressed in standard deviation score (SDS). Height at HSCT was compared with final height as well as mid-parental height. We analyzed the risk factors for affecting final adult height of patients.
RESULTS
There was a decrease in final height SDS compared to pre-transplantation height SDS (P= 0.003). All patients except one reached an adult height above -2.0 SDS of normal population. The difference between the height SDS at HSCT and the final height was -0.98+/-0.5 SDS in boys and -0.10+/-0.6 SDS in girls (P<0.01, and P=0.53 respectively). A significant decrease in height SDS was found in male (Mann-Whitney U test, P=0.001). The type of primary diseases, age at HSCT, total body irradiation, acute graft-versus-host disease did not influence the final height.
CONCLUSION
Despite the decrease in final height SDS after HSCT during childhood, the majority of patients without endocrine dysfunction spontaneously reached on a normal adult height range (above -2.0 SDS). Therefore, careful monitoring of growth after HSCT during childhood is warranted to detect the growth velocity decrease.