Problems with growth

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The brain contains the hypothalamus and the pituitary gland, which control many body processes, including growth and reproduction. At the initial dosages of radiation given to most children with leukemia (1,800 rads to the cranium), growth is usually not affected, except in younger, female patients. Effects on growth usually begin to be seen in those children who received 2,400 rads or more. If the child requires additional cranial radiation or radiation to the spine, growth can be slowed or stopped.

The growth of children who receive cranial radiation or craniospinal radiation should be followed closely. Children should be measured (sitting and standing) at every follow-up visit and their growth plotted on a chart to measure velocity.

If your child is one of the rare individuals who experiences premature puberty (before the age of 8 for girls and 10 for boys), growth may also be affected. These children may be given daily growth hormone injections to support their growth until they reach their final height.

Children who receive total body radiation prior to bone marrow transplant also may exhibit delayed growth, especially if they had cranial and/or spinal radiation previously. These children should be under the care of a pediatric endocrinologist who is experienced in follow-up care for bone marrow transplant patients.

Mandy (age 16) is a tad short-waisted, but grew seven inches on growth hormone treatment! The doctors closely monitor wingspan (that is, outstretched arms fingertip to fingertip), to make sure it correlates to height. Otherwise they may have longer arms and be out of balance. The growth hormone adds energy and good spirits as well.

Adrenal and thyroid function also need monitoring after spinal radiation.

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