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

Korean Journal of Pediatrics 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 Kim1, Hoon Kook2, Hee Jo Baek2, Dong Kyun Han2, Eun Song Song2, Young Kook Jo2, Ic Sun Choi2, Young Ok Kim2, Chan Jong Kim2, Young Jong Woo2, Soo Jin 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
일란성 쌍생아에서 혈액 및 종양 질환 치료 후 성장 및 정신신경학적 발달에 대한 비교연구
김기환1, 국훈2, 백희조2, 한동균2, 송은송2, 조영국2, 최익선2, 김영옥2, 김찬종2, 우영종2, 양수진3
1순천성가롤로병원 소아과
2전남의대 화순전남대병원 소아과학교실
3전남의대 화순전남대병원 정신과학교실
Correspondence: 
Hoon 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.
Key Words: Monozygotic twin , Growth , Neuropsychologic function , Stem cell transplantation


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