Radiation-induced hypopituitarism in children with acute lymphoblastic leukemia

Mirouliaei, Mehrdad; Shabani, Masoud; Bakhshi, Fataneh; Ordouei, Mahtab

doi:10.4103/0971-5851.113396

Cited by 5 publications

(3 citation statements)

References 20 publications

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“…They recommended a reduction in the dose of radiotherapy in such patients wherever possible. [14] It has been reported that somatotroph hormone axis is more sensitive to radiation in children than in adults. Follin et al .…”

Section: Discussionmentioning

confidence: 99%

Analysis of outcomes and prognostic factors of acute lymphoblastic leukemia patients treated by MCP841 protocol: A regional cancer center experience

et al. 2016

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Background:A dramatic improvement in the survival of acute lymphoblastic leukemia (ALL) patients in the last three decades has been observed. MCP 841 protocol is an old but effective tool with tolerable toxicities. The objective of this study was to estimate the relapse-free survival of ALL patients treated uniformly with MCP 841 protocol on the basis of various prognostic factors.Materials and Methods:The study design was retrospective and it was conducted in a regional cancer center of Northwest India. Three hundred and ten ALL patients who underwent treatment with MCP 841 protocol and regular follow-up for up to 5 years were selected for this study. Relapse-free survival was calculated by Kaplan–Meier analysis and Cox regression analysis was used to calculate the hazards ratio (HR) using Statistical Package for the Social Sciences (SPSS) software for windows version 20.0.Results:Fifty-four percent patients were <15 years of age and 69% were males. 53.2% patients were in remission at the end of 5 years of starting the treatment. Relapse-free survival at 5 years by Kaplan–Meir analysis for B-cell ALL was 62% [HR 0.67 {95% confidence interval (CI) 0.47-0.95}] with patients with unknown lineage taken as reference] while for T cell it was 28% [HR 1.41 (95% CI 1.19-1.63), P 0.001]. Patients with total leukocyte count (TLC) <1 lakh/cmm at presentation, relapse-free survival was 68% and those with TLC >1 lakh/cmm had 41% survival [HR 2.14 (1.76-2.48) with, P < 0.001].Conclusion:MCP 841 protocol is a useful tool for the treatment of ALL in children when more aggressive protocols can not be used.

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Section: Discussionmentioning

confidence: 99%

Analysis of outcomes and prognostic factors of acute lymphoblastic leukemia patients treated by MCP841 protocol: A regional cancer center experience

et al. 2016

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“…M. Mirouliaei и соавт. [7] оценили распространенность эндокринных последствий КО при остром лимфобластном лейкозе у детей. В исследование были включены 27 детей с острым лимфобластным лейкозом, получивших КО в дозе 18-24 Гр.…”

Section: распространенность и патогенез радиоиндуцированного дефицита...unclassified

Growth hormone deficiency in childhood brain tumors and acute lymphoblastic leukemia survivors

et al. 2022

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Thanks to modern treatment protocols, childhood cancer survivors (CCS) are a very fast-growing population nowadays. Cancer therapy inevitably leads to different late adverse effects, where endocrine disorders are highly prevalent, including growth hormone deficiency (GHD) which is the most common endocrine outcome after cancer treatment in childhood and contributes to impaired growth. Short stature is a big issue, which leads to problems in psychological and social adaptation of patients and reduces their quality of life. Impact of GH treatment on various physiological processes and global outcome of CCS is of great interest. Several studies have demonstrated an influence of GH and IGF-1 on the development/tumour growth, cell proliferation. In this regard, the issue of increasing the risk of cancer recurrence and/or the development of secondary neoplasms in CCS, causes a lot of controversy and is the subject of continuous evaluation. In this review, we went through the available data on the prevalence and pathogenesis of GHD following chemo- and radiotherapy, in particular after treatment of brain tumors and acute lymphoblastic leukaemia in childhood. In addition, here we discuss the existing problems in the diagnosis of GHD, the safety of GH replacement therapy, as well as the treatment algorithm of the GHD in adults.

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“…The radiation of brain or neck tumors may affect the pituitary gland, thus leading to hypopituitarism 59 . In children with acute lymphoblastic leukemia, GHD seems to be the most common hormonal deficit after cranial radiation 60 . In adults, an increasing prevalence of hypopituitarism from 12.5% after 2 years up to 90% 15 years after radiation has been reported 61 .…”

Section: Acquired Hypopituitarism Due To Brain Traumamentioning

confidence: 99%

Advances in understanding hypopituitarism

et al. 2017

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The understanding of hypopituitarism has increased over the last three years. This review provides an overview of the most important recent findings. Most of the recent research in hypopituitarism has focused on genetics. New diagnostic techniques like next-generation sequencing have led to the description of different genetic mutations causative for congenital dysfunction of the pituitary gland while new molecular mechanisms underlying pituitary ontogenesis have also been described. Furthermore, hypopituitarism may occur because of an impairment of the distinctive vascularization of the pituitary gland, especially by disruption of the long vessel connection between the hypothalamus and the pituitary. Controversial findings have been published on post-traumatic hypopituitarism. Moreover, autoimmunity has been discussed in recent years as a possible reason for hypopituitarism. With the use of new drugs such as ipilimumab, hypopituitarism as a side effect of pharmaceuticals has come into focus. Besides new findings on the pathomechanism of hypopituitarism, there are new diagnostic tools in development, such as new growth hormone stimulants that are currently being tested in clinical trials. Moreover, cortisol measurement in scalp hair is a promising tool for monitoring cortisol levels over time.

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Radiation-induced hypopituitarism in children with acute lymphoblastic leukemia

Cited by 5 publications

References 20 publications

Analysis of outcomes and prognostic factors of acute lymphoblastic leukemia patients treated by MCP841 protocol: A regional cancer center experience

Analysis of outcomes and prognostic factors of acute lymphoblastic leukemia patients treated by MCP841 protocol: A regional cancer center experience

Growth hormone deficiency in childhood brain tumors and acute lymphoblastic leukemia survivors

Advances in understanding hypopituitarism

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