Endocrine complications in pediatric patients with acute lymphoblastic leukemia

Scott Howard, Ching Hon Pui

Research output: Contribution to journalReview article

55 Citations (Scopus)

Abstract

Endocrine complications of therapy for acute lymphoblastic leukemia (ALL) are common and are potentially debilitating both during and after therapy. Growth velocity slows during therapy for ALL, especially during the first year; however, children who do not receive cranial irradiation usually reach normal adult height. While growth hormone deficiency generally occurs in patients who have received 24 Gy of cranial irradiation, it may also develop in those treated with lower doses (18 Gy) of cranial radiation or with only high-dose methotrexate. Obesity commonly occurs during therapy and persists after completion of therapy. Osteopenia can occur early during therapy for ALL and can persist for many years. Adrenal insufficiency should be suspected in any child who has recently received glucocorticoid therapy, and stress doses of steroid should be administered in the event of metabolic stress. Screening of urine is useful for early detection of hyperglycemia during therapy with glucocorticoids and L-asparaginase. The syndrome of inappropriate secretion of anti-diuretic hormone is usually associated with vincristine therapy and may be aggravated by concurrent use of azole antifungals. Finally, patients who have received 18 or 24Gy of cranial irradiation may have clinical or subclinical deficiencies of thyroid hormones.

Original languageEnglish (US)
Pages (from-to)225-243
Number of pages19
JournalBlood Reviews
Volume16
Issue number4
DOIs
StatePublished - Jan 1 2002

Fingerprint

Precursor Cell Lymphoblastic Leukemia-Lymphoma
Pediatrics
Cranial Irradiation
Therapeutics
Glucocorticoids
Radiation Dosage
Asparaginase
Azoles
Adrenal Insufficiency
Physiological Stress
Metabolic Bone Diseases
Vincristine
Secondary Prevention
Thyroid Hormones
Diuretics
Methotrexate
Hyperglycemia
Growth Hormone
Obesity
Steroids

All Science Journal Classification (ASJC) codes

  • Hematology
  • Oncology

Cite this

Endocrine complications in pediatric patients with acute lymphoblastic leukemia. / Howard, Scott; Pui, Ching Hon.

In: Blood Reviews, Vol. 16, No. 4, 01.01.2002, p. 225-243.

Research output: Contribution to journalReview article

@article{ed0ba3048a2d4622b4bfd31ed4a308b7,
title = "Endocrine complications in pediatric patients with acute lymphoblastic leukemia",
abstract = "Endocrine complications of therapy for acute lymphoblastic leukemia (ALL) are common and are potentially debilitating both during and after therapy. Growth velocity slows during therapy for ALL, especially during the first year; however, children who do not receive cranial irradiation usually reach normal adult height. While growth hormone deficiency generally occurs in patients who have received 24 Gy of cranial irradiation, it may also develop in those treated with lower doses (18 Gy) of cranial radiation or with only high-dose methotrexate. Obesity commonly occurs during therapy and persists after completion of therapy. Osteopenia can occur early during therapy for ALL and can persist for many years. Adrenal insufficiency should be suspected in any child who has recently received glucocorticoid therapy, and stress doses of steroid should be administered in the event of metabolic stress. Screening of urine is useful for early detection of hyperglycemia during therapy with glucocorticoids and L-asparaginase. The syndrome of inappropriate secretion of anti-diuretic hormone is usually associated with vincristine therapy and may be aggravated by concurrent use of azole antifungals. Finally, patients who have received 18 or 24Gy of cranial irradiation may have clinical or subclinical deficiencies of thyroid hormones.",
author = "Scott Howard and Pui, {Ching Hon}",
year = "2002",
month = "1",
day = "1",
doi = "10.1016/S0268-960X(02)00042-5",
language = "English (US)",
volume = "16",
pages = "225--243",
journal = "Blood Reviews",
issn = "0268-960X",
publisher = "Churchill Livingstone",
number = "4",

}

TY - JOUR

T1 - Endocrine complications in pediatric patients with acute lymphoblastic leukemia

AU - Howard, Scott

AU - Pui, Ching Hon

PY - 2002/1/1

Y1 - 2002/1/1

N2 - Endocrine complications of therapy for acute lymphoblastic leukemia (ALL) are common and are potentially debilitating both during and after therapy. Growth velocity slows during therapy for ALL, especially during the first year; however, children who do not receive cranial irradiation usually reach normal adult height. While growth hormone deficiency generally occurs in patients who have received 24 Gy of cranial irradiation, it may also develop in those treated with lower doses (18 Gy) of cranial radiation or with only high-dose methotrexate. Obesity commonly occurs during therapy and persists after completion of therapy. Osteopenia can occur early during therapy for ALL and can persist for many years. Adrenal insufficiency should be suspected in any child who has recently received glucocorticoid therapy, and stress doses of steroid should be administered in the event of metabolic stress. Screening of urine is useful for early detection of hyperglycemia during therapy with glucocorticoids and L-asparaginase. The syndrome of inappropriate secretion of anti-diuretic hormone is usually associated with vincristine therapy and may be aggravated by concurrent use of azole antifungals. Finally, patients who have received 18 or 24Gy of cranial irradiation may have clinical or subclinical deficiencies of thyroid hormones.

AB - Endocrine complications of therapy for acute lymphoblastic leukemia (ALL) are common and are potentially debilitating both during and after therapy. Growth velocity slows during therapy for ALL, especially during the first year; however, children who do not receive cranial irradiation usually reach normal adult height. While growth hormone deficiency generally occurs in patients who have received 24 Gy of cranial irradiation, it may also develop in those treated with lower doses (18 Gy) of cranial radiation or with only high-dose methotrexate. Obesity commonly occurs during therapy and persists after completion of therapy. Osteopenia can occur early during therapy for ALL and can persist for many years. Adrenal insufficiency should be suspected in any child who has recently received glucocorticoid therapy, and stress doses of steroid should be administered in the event of metabolic stress. Screening of urine is useful for early detection of hyperglycemia during therapy with glucocorticoids and L-asparaginase. The syndrome of inappropriate secretion of anti-diuretic hormone is usually associated with vincristine therapy and may be aggravated by concurrent use of azole antifungals. Finally, patients who have received 18 or 24Gy of cranial irradiation may have clinical or subclinical deficiencies of thyroid hormones.

UR - http://www.scopus.com/inward/record.url?scp=0036883597&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0036883597&partnerID=8YFLogxK

U2 - 10.1016/S0268-960X(02)00042-5

DO - 10.1016/S0268-960X(02)00042-5

M3 - Review article

VL - 16

SP - 225

EP - 243

JO - Blood Reviews

JF - Blood Reviews

SN - 0268-960X

IS - 4

ER -