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Endocrine assessment in childhood acute lymphocytic leukemia
Author(s) -
Fisher Joseph N.,
Aur Rhomes J. A.
Publication year - 1982
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(19820101)49:1<145::aid-cncr2820490128>3.0.co;2-o
Subject(s) - medicine , vincristine , cyclophosphamide , endocrine system , prednisone , methotrexate , chemotherapy , endocrinology , acute lymphocytic leukemia , thyroid function , hormone , total body irradiation , gastroenterology , thyroid , leukemia , lymphoblastic leukemia
Ten children ages 7 to 18 (8 girls, 2 boys) with acute lymploblastic leukemia (ALL) were studied. Remission was induced with prednisone, vincristine, and asparaginase followed by preventive central nervous system treatment with 2400 rads cobalt‐60 cranial irradiation plus intrathecal methotrexate. At the time of study all patients had been on continuation chemotherapy with two to four drugs for 2 to 21/2 years. Three patients were on mercaptopurine and methotrexate, one was on cyclophosphamide in addition, and six were on these drugs plus arabinosyl cytosine. Linear growth and bone age for height was appropriate in all. Tests included oral glucose (OGTT) and tolbutamide (TOLB) tolerance tests, ACTH infusion, thyroid function and measurement of noctural growth hormone (IRGH), and cortisol. All patients tested (9/10) had a normal OGTT. Peak glucose and insulin (IRI) values occurred at 30 minutes in 8/9 subjects (IRI range 24–143 uU/dl). IRGH responses to sleep, TOLB and following OGTT were greater than 5 ng/ml in at least one test in all, with 5/10 patients responding above this level in all three tests. Diurnal variation of cortisol was observed in all patients (8/10) studied. Thyroid function and response to ACTH was normal in all patients. No consistent changes were observed in gonadotropins. It is concluded from these results that hypothalamic pituitary function appeared to be intact despite 2400 rads of cobalt‐60 cranial radiation and ongoing chemotherapy for ALL in ten patients observed. Long‐term studies are required to exclude late endocrine complications in such children.