Growth in children with acute lymphocytic leukemia: a Pediatric Oncology Group study.
Growth in children with acute lymphocytic leukemia: a Pediatric Oncology Group study.
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急性淋巴细胞白血病儿童的生长：儿科肿瘤小组研究。
DOI：
10.1002/mpo.2950110109
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发表时间：
1983
期刊：
影响因子：
--
通讯作者：
Dickinson,L
中科院分区：
文献类型：
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作者：
Berry,DH;Elders,MJ;Crist,W;Land,V;Lui,V;Sexauer,AC;Dickinson,L
我们研究了来自5个参与机构的127名儿童急性淋巴细胞白血病（ALL）或用于治疗ALL的治疗对生长、生长激素浓度和生长调节素活性的影响。该研究（SWOG编号7581）于1975年12月启动，1979年9月停止新入组，1981年2月停止数据收集。在最初诊断时和55个月观察期间的间隔时间内获得身高、体重和生长激素和生长调节素活性的血液样本。对于初始和最终身高，低于第50百分位数的<4岁男孩的百分比显著大于预期的50%（P<0.01）。<4岁女孩的最终身高测量结果的百分位数身高分布与正常值有显著性差异（P<0.05），但其初始身高测量结果的百分位数身高分布与正常值无显著性差异。在百分位数身高分布中没有发现其他显著差异。当通过线性回归分析将自诊断ALL以来的生长速率与同龄正常儿童的预期生长进行比较时，线的斜率存在差异。ALL患儿明显较矮。平均初始生长激素和生长调节素浓度分别为6.2 ng/ml和1.3 μg/ml，与平均缓解期生长激素和生长调节素浓度分别为2.5 ng/ml和1.1 μg/ml不同。这在P<0.01时是显著的。与初始浓度相比，超过60%的患者生长激素和生长调节素多重分析的计算回归线斜率为阴性。这些数据表明，在开始治疗之前，相当数量的<4岁的儿童身材矮小，并且这种情况在整个疾病过程中持续存在。第二，在强化治疗期间或疾病的第一年，生长速度降低，此后生长速度正常。第三，生长激素和生长调节素浓度似乎在疾病发作时较高，在治疗时降低。
We have studied 127 children from 5 participating institutions as to the effect of acute lymphoblastic leukemia (ALL) or the therapy used in the treatment of ALL on growth, growth hormone concentrations, and somatomedin activity. The study (SWOG No. 7581) was initiated in December 1975 and was closed to new entry in September 1979 and to data collection in February 1981. Heights, weights, and blood samples for growth hormone and somatomedin activity were obtained at the time of initial diagnosis and at intervals during the 55 months of observation. The percentage of boys <4 years of age below the 50th percentile is significantly greater than the expected 50% for both initial and final height (P<0.01). Girls <4 years appeared to have significantly different percentile height distribution from the normal for their final height measurement (P<0.05) but not for their initial height measurement. No other significant differences in the percentile height distribution were found. When growth rate, since time of diagnosis of ALL, is compared to the expected growth of normal children of the same age by linear regression analysis, there is a difference in the slope of the lines. Children with ALL are significantly shorter. The mean initial growth hormone and somatomedin concentration, 6.2 ng/ml and 1.3 μg/ml, respectively, vs mean remission growth hormone and somatomedin of 2.5 ng/ml and 1.1 μg/ml, respectively, were different. This was significant at P<0.01. The slope of the computed regression lines for multiple analysis of growth hormone and somatomedin were negative for more than 60% of the patients when compared to the initial concentration. These data suggest that a significant number of the children <4 years of age are short prior to the onset of therapy, and this persists throughout the course of their disease. Second, there is a reduction in growth rate during intensive therapy or the first year of the disease, with a normal growth rate thereafter. Third, growth hormone and somatomedin concentrations appear to be higher at the time of onset of the disease and decrease while on therapy.