Growth deceleration in a girl treated with imatinib.

摘要

Imatinib is an inhibitor of tyrosine kinase as well as BCR-ABL, platelet-derived growth factor receptor (PDGF-R) and c-kit, and is becoming a first-line treatment for chronic myeloid leukemia (CML). In children, the long-term toxic effects related to the inhibition of tyrosine kinase are not yet well understood.A 6-year-old girl was diagnosed with BCR-ABL positive CML in the chronic phase in June 2003. After receiving imatinib (400 mg/m2 per day), molecular remission was achieved and persisted for 4 years without major side-effects. At the beginning of imatinib administration, the patient was aged 6 years, and her height was 114 cm (-0.7SD). Her growth rate decreased during these 4 years, and her height was 121 cm (-2.7SD) when she was aged 11 years.The patient followed the normal growth pattern since birth she had normal body proportions and appearance, no family history of short stature. Following extensive tests, she reached the normal GH peak after two stimulatory tests and other systemic diseases (endocrine disorder, renal failure, inflammatory disorders) were excluded.