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Abstract Growth can be divided into three phases on the basis of the infant–childhood–puberty model. Childhood growth periods relate to differences in various underlying genetic, hormonal and nutritional factors that occur during growth and ultimately lead to differences in skeletal maturation and development in an individual child. Assessment of growth may be achieved by anthropometric measurements including length, height velocity, weight, body composition including total body fat, fat-free mass, skinfold measurements including the triceps skinfold and the mid-arm circumference and body mass index. Leukemia is the most common form of cancer among children (defined as 0–14 years of age unless noted otherwise) in the United States and Canada. Together, acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML) comprise about 30% of cancers among children, although ALL occurs at about five times the rate of AML. Treatment of childhood leukemia includes chemotherapeutic agents administrated in many therapeutic protocols, cranial irradiation for treatment of CNS leukemia and other modalities such as stem cell transplantation. Approximately two-thirds of pediatric leukemia survivors develop some type of late side effects that can be attributed directly to their previous treatment. Endocrine disorders represent about 40% of these late effects, and the most important one is growth deficit. Growth deficit is generally attributed to growth hormone (GH) deficiency after exposure to cranial irradiation therapy (CRT). Chemotherapy has been less commonly associated with growth deficit. Contributing factors for growth deficits after leukemia treatment include age at diagnosis where younger children are more prone to develop later height deficits and gender and puberty where the majority of the reviewed studies report that the amount of final height loss in girls was significantly higher than in boys. Early puberty in girls with ALL has been reported by several investigators. According to these authors, deficits in final height could be ascribed, at least in part, to this phenomenon. |