Growth in children after bone marrow transplantation: Busulfan plus cyclophosphamide versus cyclophosphamide plus total body irradiation

John R. Wingard, Leslie P. Plotnick, Christine S. Freemer, Mariana Zahurak, Steven Piantadosi, Dawn F. Miller, Huibert M. Vriesendorp, Andrew M Yeager, George W. Santos

Research output: Contribution to journalArticle

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Abstract

Growth was assessed during the first and second years following bone marrow transplantation (BMT) in 47 children treated by either busulfan plus cyclophosphamide (BU/CY) (n = 24) or cyclophosphamide plus fractionated total body irradiation (CY/TBI) (n = 23). Before transplant, the median height was only 0.2 SD below age- and sex-adjusted means (range, -2.5 to +3.0). Height was greater than 2.0 SD below normal in only three patients (6%). The pretransplant heights were comparable in the BU/CY and CY/TBI groups (-0.1 v -0.6 SD, P = .35). Following transplant, median 1- and 2-year heights were 0.7 and 0.9 SD below normal, respectively. Growth rates were 2.2 SD and 1.4 SD below normal during the first and second years, respectively. Growth rates were greater than 2.0 SD below normal in 24 of 47 (51%) at 1 year and in 12 of 31 (39%) at 2 years after transplant. Growth rates in patients treated with BU/CY were comparable to those treated with CY/TBI during both years: -2.5 versus -1.7 SD during the first year (P = .19, Wilcoxon), and -1.5 versus -1.1 SD during the second year (P = .61). Growth rates during the second year correlated with growth rates during the first year (r = .36, P = .046). Growth rates during the first year were lower in patients who had been given prior cranial irradiation, those who were near pubertal age at the time of transplant, and those who were transplanted for a disease other than acute lymphoblastic leukemia (ALL). During the second year, poor rates of growth were associated only with the use of corticosteroids after transplant.

Original languageEnglish (US)
Pages (from-to)1068-1073
Number of pages6
JournalBlood
Volume79
Issue number4
StatePublished - Feb 15 1992
Externally publishedYes

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Busulfan
Whole-Body Irradiation
Transplants
Bone Marrow Transplantation
Cyclophosphamide
Bone
Irradiation
Growth
Cranial Irradiation
Adrenal Cortex Hormones
Precursor Cell Lymphoblastic Leukemia-Lymphoma

ASJC Scopus subject areas

  • Hematology

Cite this

Wingard, J. R., Plotnick, L. P., Freemer, C. S., Zahurak, M., Piantadosi, S., Miller, D. F., ... Santos, G. W. (1992). Growth in children after bone marrow transplantation: Busulfan plus cyclophosphamide versus cyclophosphamide plus total body irradiation. Blood, 79(4), 1068-1073.

Growth in children after bone marrow transplantation : Busulfan plus cyclophosphamide versus cyclophosphamide plus total body irradiation. / Wingard, John R.; Plotnick, Leslie P.; Freemer, Christine S.; Zahurak, Mariana; Piantadosi, Steven; Miller, Dawn F.; Vriesendorp, Huibert M.; Yeager, Andrew M; Santos, George W.

In: Blood, Vol. 79, No. 4, 15.02.1992, p. 1068-1073.

Research output: Contribution to journalArticle

Wingard, JR, Plotnick, LP, Freemer, CS, Zahurak, M, Piantadosi, S, Miller, DF, Vriesendorp, HM, Yeager, AM & Santos, GW 1992, 'Growth in children after bone marrow transplantation: Busulfan plus cyclophosphamide versus cyclophosphamide plus total body irradiation', Blood, vol. 79, no. 4, pp. 1068-1073.
Wingard JR, Plotnick LP, Freemer CS, Zahurak M, Piantadosi S, Miller DF et al. Growth in children after bone marrow transplantation: Busulfan plus cyclophosphamide versus cyclophosphamide plus total body irradiation. Blood. 1992 Feb 15;79(4):1068-1073.
Wingard, John R. ; Plotnick, Leslie P. ; Freemer, Christine S. ; Zahurak, Mariana ; Piantadosi, Steven ; Miller, Dawn F. ; Vriesendorp, Huibert M. ; Yeager, Andrew M ; Santos, George W. / Growth in children after bone marrow transplantation : Busulfan plus cyclophosphamide versus cyclophosphamide plus total body irradiation. In: Blood. 1992 ; Vol. 79, No. 4. pp. 1068-1073.
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title = "Growth in children after bone marrow transplantation: Busulfan plus cyclophosphamide versus cyclophosphamide plus total body irradiation",
abstract = "Growth was assessed during the first and second years following bone marrow transplantation (BMT) in 47 children treated by either busulfan plus cyclophosphamide (BU/CY) (n = 24) or cyclophosphamide plus fractionated total body irradiation (CY/TBI) (n = 23). Before transplant, the median height was only 0.2 SD below age- and sex-adjusted means (range, -2.5 to +3.0). Height was greater than 2.0 SD below normal in only three patients (6{\%}). The pretransplant heights were comparable in the BU/CY and CY/TBI groups (-0.1 v -0.6 SD, P = .35). Following transplant, median 1- and 2-year heights were 0.7 and 0.9 SD below normal, respectively. Growth rates were 2.2 SD and 1.4 SD below normal during the first and second years, respectively. Growth rates were greater than 2.0 SD below normal in 24 of 47 (51{\%}) at 1 year and in 12 of 31 (39{\%}) at 2 years after transplant. Growth rates in patients treated with BU/CY were comparable to those treated with CY/TBI during both years: -2.5 versus -1.7 SD during the first year (P = .19, Wilcoxon), and -1.5 versus -1.1 SD during the second year (P = .61). Growth rates during the second year correlated with growth rates during the first year (r = .36, P = .046). Growth rates during the first year were lower in patients who had been given prior cranial irradiation, those who were near pubertal age at the time of transplant, and those who were transplanted for a disease other than acute lymphoblastic leukemia (ALL). During the second year, poor rates of growth were associated only with the use of corticosteroids after transplant.",
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AU - Zahurak, Mariana

AU - Piantadosi, Steven

AU - Miller, Dawn F.

AU - Vriesendorp, Huibert M.

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AU - Santos, George W.

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N2 - Growth was assessed during the first and second years following bone marrow transplantation (BMT) in 47 children treated by either busulfan plus cyclophosphamide (BU/CY) (n = 24) or cyclophosphamide plus fractionated total body irradiation (CY/TBI) (n = 23). Before transplant, the median height was only 0.2 SD below age- and sex-adjusted means (range, -2.5 to +3.0). Height was greater than 2.0 SD below normal in only three patients (6%). The pretransplant heights were comparable in the BU/CY and CY/TBI groups (-0.1 v -0.6 SD, P = .35). Following transplant, median 1- and 2-year heights were 0.7 and 0.9 SD below normal, respectively. Growth rates were 2.2 SD and 1.4 SD below normal during the first and second years, respectively. Growth rates were greater than 2.0 SD below normal in 24 of 47 (51%) at 1 year and in 12 of 31 (39%) at 2 years after transplant. Growth rates in patients treated with BU/CY were comparable to those treated with CY/TBI during both years: -2.5 versus -1.7 SD during the first year (P = .19, Wilcoxon), and -1.5 versus -1.1 SD during the second year (P = .61). Growth rates during the second year correlated with growth rates during the first year (r = .36, P = .046). Growth rates during the first year were lower in patients who had been given prior cranial irradiation, those who were near pubertal age at the time of transplant, and those who were transplanted for a disease other than acute lymphoblastic leukemia (ALL). During the second year, poor rates of growth were associated only with the use of corticosteroids after transplant.

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