We investigated whether the relative increased height of childhood acute lymphoblastic leukemia (ALL) survivors at diagnosis was due to referral bias, the height of California children, socio-economic status, or race/ethnicity. We reviewed the records of all Pediatric Oncology referrals to our institution from 1988 to 2007. Height at diagnosis, sex, age at and date of diagnosis, date of birth, diagnosis, race/ethnicity, and socio-economic status were evaluated. Heights were standardized by z score from age and sex norms for US children. Of the 883 cases, 180 were excluded (Down syndrome, noncancer diagnosis, data at relapse only, incorrect height measurement, or major growth disturbance). ALL patients were taller than those with other cancers and US children. Age at and date of diagnosis and date of birth had no effect. Whites, boys, and those with private insurance had higher height z scores. Multivariable analysis identified diagnosis and race/ethnicity as significant. ALL children and adolescents were taller and black and Asian children shorter than white children. The mean height increase for those with ALL was 1.3 cm. The reason for the increased height of these patients is unknown, but is not due to referral patterns, having childhood cancer, or the racial/ethnic makeup of California children.
Department of Pediatrics, University of California, Davis School of Medicine, Sacramento, CA
Present Address: Tannie Huang, MD, Division of Pediatric Hematology/Oncology, UC San Francisco, 505 Parnassus Ave., San Francisco, CA 94143.
The authors declare no conflict of interest.
Reprints: Jonathan M. Ducore, MD, MPH, Department of Pediatrics, University of California, Davis School of Medicine, 2450 48th Street, Suite 1600 ASB, Sacramento, CA 95817 (e-mail: firstname.lastname@example.org).
Received December 6, 2012
Accepted April 16, 2013