Final Height of Children after Stem Cell Transplantation

ABSTRACT

BACKGROUND: Growth impairment is a common complication after hematopoietic stem cell transplantation (SCT). The aim of this study was to evaluate the final adult height of patients who underwent SCT in childhood and to identify the factors that influence long-term growth in these patients. METHODS: A retrospective review of 15 children who underwent SCT before puberty at Chonnam National University Hospital and reached final adult height was undertaken. To assess the severity of height reduction and to monitor the height changes longitudinally, height measurements of each patient both at the time of SCT and the final height were expressed as the height standard deviation score (SDS). RESULTS: Seven children were males and eight were females with a median age of 12.8+/-2.4 years (range, 6.3~14.7) at SCT. The median follow-up period was 7.1+/-2.0 years (range, 4.5~11.1) and their final height was achieved at 18.1+/-1.5 years (range, 17.0~21.8). Final height SDS values were within normal for the healthy population in all except two who had short stature (below -2.0 SDS). No patient achieved height values greater than +2.0 SDS. The final height SDS value (-0.5+/-1.2) was not decreased from the height SDS value at SCT (-0.8+/-0.8). The younger age group at SCT (6.1~10.0 years, n=5) showed significantly lower final height SDS and greater Delta SDS than the older age group (10.1~15.0 years, n=10) (-1.5+/- 0.6 vs. -0.1+/-1.1, P.05) and the final height SDS (P<.05). The gender, type of disease, donor type or the presence of chronic graft-versus-host disease did not influence height. CONCLUSION: Growth impairment may be encountered in children after SCT. A younger age at transplant and irradiation were found to be factors associated with reduced final height. However, most patients (13/15) reached a final adult height within normal limits for the general healthy population.