All issues > Volume 50(2); 2007

Original Article

Korean J Pediatr. 2007;50(2):182-189. Published online February 15, 2007.

Comparison of growth and neuropsychological function after treatment for hematologic and oncologic diseases in monozygotic twins

Gi Hwan GH Kim¹, Hoon H Kook², Hee Jo HJ Baek², Dong Kyun DK Han², Eun Song ES Song², Young Kook YK Jo², Ic Sun IS Choi², Young Ok YO Kim², Chan Jong CJ Kim², Young Jong YJ Woo², Soo Jin SJ Yang³

¹Department of Pediatrics, St. Carollos Hospital, Suncheon, Korea
²Departments of Pediatrics, Chonnam National University Hwasun Hospital Chonnam National University Medical School, Hwasun
³Departments of Psychiatry, Chonnam National University Hwasun Hospital Chonnam National University Medical School, Hwasun

Correspondence Hoon H Kook ,Email: hoonkook@chonnam.ac.kr

Abstract

Purpose
: The primary purpose of this study was to evaluate the growth and neuropsychologic function following treatments for pediatric hematologic and oncologic diseases. Healthy monozygotic twins served as ideal controls for comparison to exclude possible confounding factors.
Methods
: Seven children treated with various hematologic and oncologic diseases were included in the study: acute lymphoblastic leukemia (ALL; n=2), Diamond-Blackfan anemia twins (n=2), and aplastic anemia (n=3). The median age at the diagnosis was 5.2 (0.3-15) years. The median duration of follow-up was 7.2 (4.9-10) years. Controls were healthy monozygotic twins. Growth was measured and the percentile channels were evaluated sequentially for patients. The K-WISC III was applied and compared in 5 pairs of patients and controls.
Results
: Similar growth profiles were noted for the twins. The percentiles at diagnosis was 3-10 in 3, 25-50 in 2, and 50-75 in 2 cases. All patients stayed in their growth percentiles through follow-up, except for 1 patient who became obese. For IQ tests, the mean behavioral, verbal and full scale IQ scores of patients were 88.0, 93.8, and 89.8, respectively, and those from their corresponding controls were 92.2, 97.0, and 91.7 (P>0.05). However, 2 children who were treated for ALL had lower IQ scores.
Conclusion
: Similar growth profiles were observed in the monozygotic twins in terms of height and weight. The IQ scores of patients were similar to those of monozygotic twins. However, prophylactic CNS-directed therapy for leukemia might adversely affect the IQ scores. A further prospective study on larger number of twins is warranted.

Keywords :Monozygotic twin , Growth , Neuropsychologic function , Stem cell transplantation