Search

Aim: To evaluate the character of growth disorders and risk factors of their development after treatment of acute lympho- blastic leukemia (ALL) patients in childhood., Materials and Methods: In this study 25 patients (16 women and 9 men) who had undergone treatment for ALL in childhood were assessed. Patients underwent polychemo- therapy and cranial irradiation. Average age at the time of the survey - 21,2±3,9 years; average age at the time of treatment - 6,9±3,4 years; average follow-up - 13,8±4,9 years. Healthy volunteers were included in the control group (10 women and 6 men) at the age of 25,9±3,6 years. Patients' anthropometric and laboratory parameters were measured., Results: SDS of the final height in ALL survivors was significantly lower in comparison with the control group (p=0,009). ALL survivors had significantly higher difference between final and target height compared to control (p=0,049). 4 of 8 men (50,0% CI: 24,5% - 75,5%) and 13 of 15 women (86,7% CI:68,1-95,7%) have reached the target height. 73,9% (CI: 56,3% - 86,8%) of ALL survivors have reached target height which is significantly lower than in the control group (p<0,001). We found a significant backward correlation be- tween the age at the time of treatment and reaching of the target height (r=-0,415, p=0,049). ALL survivors also suffered from obesity - 12%, dyslipidemia - 36,8%, insulin resistance - 66,7%., Conclusion: Treatment for ALL in childhood causes a de- crease of final height. Its main risk factor is the age at the time of the treatment. ALL survivors are diagnosed with the other endocrine disorders and they need an endocrinologist's observation.

A total of 40 patients (median age 6 years, range 1-28 years) with high-risk malignant brain tumors received a single (n = 35) or tandem (n = 5) high-dose chemotherapy (HDCT) with autologous hemopoietic stem cell transplantation (auto-HSCT). The 2-year OS and DFS are 52% and 47%, accordingly, with median follow-up of 24 (range 2-96) months. The patients without complete response at the time of auto-HSCT had worst prognosis with 53% DFS in patients with partial remission and 25% in patients with disease stabilization (p = 0.001). Patients with relapsed tumor had worse prognosis, than high-risk patients in the first remission with DFS 26% and 62%, accordingly (p=0.02). The relapse rate also correlated with patient's age (38% DFS in patients younger, than 4 years and 60% in older patients, p = 0.005) and tumor morphology (63% DFS in patients with medulloblastoma, 60% in patients with germ-cell tumors, 45% in other embryonal CNS tumors, p = 0.05). The 4th-grade transplant-related toxicity and mortality rates were observed in 13% and 18% of patients, accordingly. Therefore, HDCT with auto-HSCT in young patients with high-risk CNS tumors is characterized by acceptable toxicity and allows improving overall therapy results.

The day hospital proved effective for diagnosis and treatment of pediatric cancer. It is more cost-effective and less emotionally traumatic for patients than the usual hospital.