Chemotherapy plays a major role in the inhibition of catch-up growth during maintenance therapy for childhood acute lymphoblastic leukemia

Pediatrics. 1995 Oct;96(4 Pt 1):693-5.

Abstract

Objective: In children treated for acute lymphoblastic leukemia (ALL), catch-up growth occurs after cessation of therapy and not during maintenance therapy. In this study we investigated whether this inhibition of catch-up growth during maintenance treatment is attributable to the influence of chemotherapy or to the influence of corticosteroids.

Patients: Forty-six children treated for ALL were included in the study. In 27 patients maintenance therapy comprised vincristine (VCR), prednisone (Pred), or dexamethasone (Dexa) alternated with 6-mercaptopurine (6-MP) and methotrexate (MTX) and 19 patients received maintenance therapy with 6-MP and MTX only. Treatment did not include cranial irradiation.

Results: Statural growth during maintenance treatment was comparable in both groups over the study period of 1.5 years.

Conclusion: Chemotherapy with 6-MP and MTX, and not corticosteroids, is the main factor that prevents catch-up growth from occurring during maintenance therapy for ALL.

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / adverse effects*
  • Child
  • Child, Preschool
  • Female
  • Growth / drug effects
  • Growth Disorders / chemically induced*
  • Humans
  • Infant
  • Male
  • Mercaptopurine / administration & dosage
  • Mercaptopurine / adverse effects
  • Methotrexate / administration & dosage
  • Methotrexate / adverse effects
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / drug therapy*
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / physiopathology*

Substances

  • Mercaptopurine
  • Methotrexate