Growth hormone was given to 13 children (nine boys, four girls) with acute leukaemia who had undergone treatment with cyclophosphamide and total body irradiation before bone marrow transplantation. Mean age at total body irradiation and bone marrow transplantation was 9.0 years (range 3.7-15.8). Endocrinological investigation was carried out at a mean of 2.0 years (range 0.4-4.0) after bone marrow transplantation. Peak serum growth hormone responses to hypoglycaemia were less than 10.0 micrograms/l (less than 20.0 mU/l) in 10, 10.5 micrograms/l (21.0 mU/l) in one, greater than 16.0 micrograms/l (greater than 32.0 mU/l) in two patients. Mean age of the patients at the start of growth hormone treatment was 12.2 years (range 5.8-18.2). The mean time between total body irradiation and bone marrow transplantation and the start of growth hormone treatment was 3.2 years (range, 1.1-5.0). Height velocity SD score (SD) increased from a mean pretreatment value of -1.27 (0.65) to + 0.22 (0.81) in the first year, +0.16 (1.11) in the second year, and +0.42 (0.71) in the third year of treatment. Height SD score (SD) changed only slightly from -1.52 (0.42) to -1.50 (0.47) in the first year, to -1.50 (0.46) in the second year, and -1.74 (0.92) in the third year. Measurement of segmental proportions showed no significant increase in subischial leg length from -0.87 (0.67) to -0.63 (0.65) in the first year, to -0.58 (0.70) in the second year, and -0.80 (1.14) in the third year of treatment. Our data indicate that children who have undergone total body irradiation and bone marrow transplantation respond to treatment with growth hormone in either of two dose regimens, with an increase in height velocity that is adequate to restore a normal growth rate but not to 'catch up', and that total body irradiation impairs not only spinal but also leg growth, possibly by a direct effect of irradiation on the epiphyses and soft tissues.
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机译：向13名患有急性白血病的儿童（分别在骨髓移植之前接受了环磷酰胺和全身照射的治疗）给予了生长激素。全身照射和骨髓移植的平均年龄为9.0岁（范围3.7-15.8）。骨髓移植后平均2.0年（范围0.4-4.0）进行内分泌学调查。十人血清对低血糖的峰值血清生长激素反应小于10.0微克/升（小于20.0 mU / l），其中一个为10.5微克/升（21.0 mU / l），大于16.0微克/升（大于32.0 mU / l）两名患者。开始生长激素治疗的患者平均年龄为12.2岁（范围5.8-18.2）。从全身照射到骨髓移植到开始生长激素治疗的平均时间为3.2年（范围1.1-5.0）。身高速度SD分数（SD）从第一年的平均预处理值-1.27（0.65）增至+ 0.22（0.81），第二年的+0.16（1.11）和第三年的+0.42（0.71）治疗。身高SD评分（SD）从第一年的-1.52（0.42）到第一年的-1.50（0.47）略有变化，第二年的变化为-1.50（0.46），第三年的变化为-1.74（0.92）。分段比例的测量显示，坐骨下腿长度从第一年的-0.87（0.67）到第一年的-0.63（0.65）没有显着增加，第二年增加到-0.58（0.70），第三年增加到-0.80（1.14）治疗。我们的数据表明，接受全身照射和骨髓移植的儿童在两种剂量方案中的任何一种下均对生长激素的治疗有反应，其身高速度的增加足以恢复正常的生长速度，但不能“追赶” ，并且全身辐射不仅会损害脊柱，还会损害腿部生长，这可能是由于辐射直接影响骨phy和软组织。
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