- Email: [email protected]
A condensed table for predicting adult stature
440
Brief cfinical and laboratory observations
An increasing number of children with ALL are surviving longer; therefore, therapy for this disease must be designed to minimize iatrogenic neurologic sequelae. The reported frequency of neurologic sequelae is variable and there is no agreement as to how therapy influences CNS toxicity a n d / o r functional impairment2 However, since significant neurologic complications may result from CNS therapy, identification of prognostic indicators and selection of the least toxic yet effective CNS therapy are important objectives currently under investigation. 1~ 11 Our observations tentatively suggest that severe EEG abnormalities present at the time of diagnosis prior to therapy may reflect an ill-defined cerebral disturbance which predisposes the patient to an increased risk of early CNS therapy neurotoxicity. Whether the combination of these findings is also predictive for latent forms of neurotoxicity or the more severe sequelae of progressive leukoencephalopathy remains to be determined. REFERENCES
1. Shaw RK, Moore EW, Freireich EJ, and Thomas LB: Meningeal leukemia, Neurology 10:823, 1960. 2. Iannetti P, Multari G, Del Principe D, Nervi C, and Digilio G: Electroencephalographic findings in patients with acute lymphatic leukemia treated by radiotherapy of the central nervous system, in Metcalf D, Condorelli M, and Peschle C,
The Journal of Pediatrics March 1981
3. 4.
5. 6.
7. 8. 9. 10.
11.
editors: International conference on leukemia and aplastic anemia, Rome, 1974, 11 Pensiero Scientifico, p 598. Onuma A, Uinuma K, and Hayashi T: Electroencephalographic findings in acute childhood leukemias, Jpn J Clin Hematol 19:107, 1978. Butcher DM, Hardisty RM, Lange L, and Pampliglione G: EEG studies in children with leukemia, Electroencephalogr Clin Neurophysiol 28:209, 1970. Moure JMB, and Sullivan M: EEG changes in children with leukaemia during chemotherapy, Electroencephalogr Clin Neurophysiol 38:429, 1975. Garwicz S, Aronson AS, Elmquist D, and Landberg T: Postirradiation syndrome and EEG findings in children with acute lymphoblastic leukaemia, Acta Paediatr Scand 64:399, 1975. Allen JC; The effects of cancer therapy on the nervous system, J P~DIATR93:903, 1978. Pochedly C: Neurotoxicity due to CNS therapy for leukemia, Med Pediatr Oncol 3:101, 1977. Obetz SW, Smithson WA, Groover RV, et al.: Neuropsychologic follow-up study of children with acute lymphoblastic leukemia, Am J Pediatr Hematol/Oncol 1:207, 1979. Nesbit ME, Salther HN, Robison LL, et al: Presymptomatic CNS treatment in childhood acute lymphoblastic leukemia: Comparison between 1800 and 2400 rads, Proc Am Assoc Cancer Res 20:343, 1979 (abstr). Bode U, Otiff A, Bercu BB, et al: Absence of CT brain scan and endocrine abnormalities with less intensive CNS prophylaxis, Am J Pediatr Hematol/Oncol 2:21, 1980.
A condensed table for predicting adult stature Ernest M. Post, M.D.,* and Robert A. Richman, M.D., Syracuse, N.Y.
I ~ 1952 Bayley and Pinneau I published a set of 11 tables for predicting adult height from skeletal age 2 and current height. More recently two other methods 3.' have been developed, but it remains controversal whether they are more accurate?, 6 The Bayley-Pinneau method is the least complicated one and is still widely used. (Science Citation Index: 1978 and 1979). The Table presented here is condensed from their data for simplicity, clarity, and easier clinical application. It shows the decimal fraction of adult height attained at each bone age for boys and girls whose skeletal age is average (within one year), retarded, or advanced compared to chronologic age. The decimal fraction is located in the row for the patient's skeletal age *Reprint address: Department of Pediatrics, State University Hospital, 750 East Adams St., Syracuse, N Y 13210.
(years and months), under the appropriate column. Adult height prediction is calculated by dividing the height by the decimal fraction. For example, a 106/12-year-old boy who is 130.0 cm tall and has a bone age of 86/12years will have a height prediction of present height decimal fraction
m
130.0 0.779
166.9 cm.
This method is equally suitable for height in inches. REFERENCES 1. Bayley N, and Pinneau SR: Tables for predicting adult height from skeletal age: Revised for use with the GreulichPyle hand standards; J P~DIATR50:432, 1952. 2. Greulich WW, and Pyle SI: Radiographic atlas of skeletal development of the hand and wrist, Stanford, Calif. 1959, Stanford University Press, p 190.
0022-3476/81/030440+03500.30/0 9 1981 The C. V. Mosby Co.
Volume 98 Number 3
Brief clinical and laboratory observations
44 1
Table. Fraction o f adult height attained at each b o n e age
Bone age yr-mo 6-0 6-3 6-6 6-9 7-0 7-3 7-6 7-9 8-0 8-3 8-6 8-9 9-0 9-3 9-6 9-9 10-0 10-3 10-6 10-9 11-0 11-3 11-6 11-9 12-0 12-3 12-6 12-9 13-0 13-3 13-6 13-9 14-0 14-3 14-6 14-9 15-0 15-3 15-6 15-9 16-0 16-3 16~6 16-9 17-0 17-3 17-6 17-9 18-0 18-3 18-6
Gir~ Retarded 0.733 0.742 0.751 0.763 0.770 0.779 0.788 0.797 0.804 0.813 0.823 0.836 0.841 0.851 0.858 0.866 0,874 0,884 0.896 0.907 0.918 0.922 0.926 0.929 0.932 0.942 0.949 0.957 0.964 0.971 0.977 0.981 0.983 0.986 0.989 0.992 0.994 0.995 0.996 0,997 0.998 0.999 0.999 0.9995 1.00
A verage*
Boys I
Advanced
0.720 0.729 0.738 0.751 0,757 0.765 0.772 0.782 0.790 0.801 0.810 0.821 0.827 0.836 0.844 0.853 0.862 0.874 0.884 0.896 0,906 0.910 0.914 0.918 0.922 0.932 0.941 0.950 0.958 0.967 0.974 0.978 0.980 0.983 0.986 0,988 0.990 0.991 0.993 0.994 0.996 0.996 0.997 0.998 0.999
0.712 0.722 0.732 0.742 0.750 0.760 0.771 0.784 0.790 0.800 0.809 0.819 0.828 0.841 0.856 0.870 0.883 0.887 0.891 0.897 0.901 0.913 0.924 0.935 0.945 0.955 0.963 0.968 0.972 0.977 0.980 0.983 0.986 0.988 0.990 0.992 0.993 0.994 0.995 0.997 0.998
0.9995
0.9995
1.00
*Average: Bone age within one year of chronologicage.
Retarded 0.680 0.690 0.700 0.709 0.718 0.728 0.738 0.747 0.756 0.765 0.773 0.779 0.786 0.794 0,800 0.807 0.812 0.816 0.819 0.821 0.823 0.827 0.832 0.839 0.845 0.852 0.860 0.869 0.880
l
Average*
0.695 0.702 0.709 0,716 0.723 0.731 0.739 0.746 0.752 0.761 0.769 0,777 0.784 0.791 0.795 0.800 0.804 0.812 0.818 0.827 0.834 0.843 0.853 0.863 0.876 0.890 0,902 0.914 0.927 0.938 0.948 0.958 0.968 0.973 0.976 0.980 0.982 0.985 0.987 0.989 0.991 0.993 0.994 0.995 0.996 0.998 1.00
l Advanced
0.670 0.676 0.683 0.689 0.696 0.703 0.709 0.715 0.720 0.728 0.734 0.741 0.747 0.753 0.758 0.763 0.767 0.776 0.786 0.800 0.809 0.818 0.828 0.839 0.850 0.863 0.875 0.890 0.905 0.918 0.930 0.943 0.958 0.967 0.971 0.976 0.980 0.983 0.985 0.988 0.990
442
Brief clinical and laboratory observations
3. Tanner JM, Whitehouse RH, Marshall WA, Healy M JR, and Goldstein H: Assessment of skeletal maturity and prediction of adult height: TW2 method, New York, 1975, Academic Press, Inc. 4. Roche AF, Wainer H, and Thissen D: The RWT method for the prediction of adult stature, Pediatrics 56:1026, 1975.
The Journal of Pediatrics March 1981
5. Zachmann M, Sobradillo B, Frank M, Frisch H, and Prader A: Bayley-Pinneau, Roche-Wainer-Thissen, and Tanner height predictions in normal children and in patients with various pathologic conditions, J PEDtA'rR 93:749, 1978. 6. Lenko HL: Prediction of adult height with various methods in Finnish children, Acta Paediatr Scand 68:85, 1979.
Brief cfinical and laboratory observations
An increasing number of children with ALL are surviving longer; therefore, therapy for this disease must be designed to minimize iatrogenic neurologic sequelae. The reported frequency of neurologic sequelae is variable and there is no agreement as to how therapy influences CNS toxicity a n d / o r functional impairment2 However, since significant neurologic complications may result from CNS therapy, identification of prognostic indicators and selection of the least toxic yet effective CNS therapy are important objectives currently under investigation. 1~ 11 Our observations tentatively suggest that severe EEG abnormalities present at the time of diagnosis prior to therapy may reflect an ill-defined cerebral disturbance which predisposes the patient to an increased risk of early CNS therapy neurotoxicity. Whether the combination of these findings is also predictive for latent forms of neurotoxicity or the more severe sequelae of progressive leukoencephalopathy remains to be determined. REFERENCES
1. Shaw RK, Moore EW, Freireich EJ, and Thomas LB: Meningeal leukemia, Neurology 10:823, 1960. 2. Iannetti P, Multari G, Del Principe D, Nervi C, and Digilio G: Electroencephalographic findings in patients with acute lymphatic leukemia treated by radiotherapy of the central nervous system, in Metcalf D, Condorelli M, and Peschle C,
The Journal of Pediatrics March 1981
3. 4.
5. 6.
7. 8. 9. 10.
11.
editors: International conference on leukemia and aplastic anemia, Rome, 1974, 11 Pensiero Scientifico, p 598. Onuma A, Uinuma K, and Hayashi T: Electroencephalographic findings in acute childhood leukemias, Jpn J Clin Hematol 19:107, 1978. Butcher DM, Hardisty RM, Lange L, and Pampliglione G: EEG studies in children with leukemia, Electroencephalogr Clin Neurophysiol 28:209, 1970. Moure JMB, and Sullivan M: EEG changes in children with leukaemia during chemotherapy, Electroencephalogr Clin Neurophysiol 38:429, 1975. Garwicz S, Aronson AS, Elmquist D, and Landberg T: Postirradiation syndrome and EEG findings in children with acute lymphoblastic leukaemia, Acta Paediatr Scand 64:399, 1975. Allen JC; The effects of cancer therapy on the nervous system, J P~DIATR93:903, 1978. Pochedly C: Neurotoxicity due to CNS therapy for leukemia, Med Pediatr Oncol 3:101, 1977. Obetz SW, Smithson WA, Groover RV, et al.: Neuropsychologic follow-up study of children with acute lymphoblastic leukemia, Am J Pediatr Hematol/Oncol 1:207, 1979. Nesbit ME, Salther HN, Robison LL, et al: Presymptomatic CNS treatment in childhood acute lymphoblastic leukemia: Comparison between 1800 and 2400 rads, Proc Am Assoc Cancer Res 20:343, 1979 (abstr). Bode U, Otiff A, Bercu BB, et al: Absence of CT brain scan and endocrine abnormalities with less intensive CNS prophylaxis, Am J Pediatr Hematol/Oncol 2:21, 1980.
A condensed table for predicting adult stature Ernest M. Post, M.D.,* and Robert A. Richman, M.D., Syracuse, N.Y.
I ~ 1952 Bayley and Pinneau I published a set of 11 tables for predicting adult height from skeletal age 2 and current height. More recently two other methods 3.' have been developed, but it remains controversal whether they are more accurate?, 6 The Bayley-Pinneau method is the least complicated one and is still widely used. (Science Citation Index: 1978 and 1979). The Table presented here is condensed from their data for simplicity, clarity, and easier clinical application. It shows the decimal fraction of adult height attained at each bone age for boys and girls whose skeletal age is average (within one year), retarded, or advanced compared to chronologic age. The decimal fraction is located in the row for the patient's skeletal age *Reprint address: Department of Pediatrics, State University Hospital, 750 East Adams St., Syracuse, N Y 13210.
(years and months), under the appropriate column. Adult height prediction is calculated by dividing the height by the decimal fraction. For example, a 106/12-year-old boy who is 130.0 cm tall and has a bone age of 86/12years will have a height prediction of present height decimal fraction
m
130.0 0.779
166.9 cm.
This method is equally suitable for height in inches. REFERENCES 1. Bayley N, and Pinneau SR: Tables for predicting adult height from skeletal age: Revised for use with the GreulichPyle hand standards; J P~DIATR50:432, 1952. 2. Greulich WW, and Pyle SI: Radiographic atlas of skeletal development of the hand and wrist, Stanford, Calif. 1959, Stanford University Press, p 190.
0022-3476/81/030440+03500.30/0 9 1981 The C. V. Mosby Co.
Volume 98 Number 3
Brief clinical and laboratory observations
44 1
Table. Fraction o f adult height attained at each b o n e age
Bone age yr-mo 6-0 6-3 6-6 6-9 7-0 7-3 7-6 7-9 8-0 8-3 8-6 8-9 9-0 9-3 9-6 9-9 10-0 10-3 10-6 10-9 11-0 11-3 11-6 11-9 12-0 12-3 12-6 12-9 13-0 13-3 13-6 13-9 14-0 14-3 14-6 14-9 15-0 15-3 15-6 15-9 16-0 16-3 16~6 16-9 17-0 17-3 17-6 17-9 18-0 18-3 18-6
Gir~ Retarded 0.733 0.742 0.751 0.763 0.770 0.779 0.788 0.797 0.804 0.813 0.823 0.836 0.841 0.851 0.858 0.866 0,874 0,884 0.896 0.907 0.918 0.922 0.926 0.929 0.932 0.942 0.949 0.957 0.964 0.971 0.977 0.981 0.983 0.986 0.989 0.992 0.994 0.995 0.996 0,997 0.998 0.999 0.999 0.9995 1.00
A verage*
Boys I
Advanced
0.720 0.729 0.738 0.751 0,757 0.765 0.772 0.782 0.790 0.801 0.810 0.821 0.827 0.836 0.844 0.853 0.862 0.874 0.884 0.896 0,906 0.910 0.914 0.918 0.922 0.932 0.941 0.950 0.958 0.967 0.974 0.978 0.980 0.983 0.986 0,988 0.990 0.991 0.993 0.994 0.996 0.996 0.997 0.998 0.999
0.712 0.722 0.732 0.742 0.750 0.760 0.771 0.784 0.790 0.800 0.809 0.819 0.828 0.841 0.856 0.870 0.883 0.887 0.891 0.897 0.901 0.913 0.924 0.935 0.945 0.955 0.963 0.968 0.972 0.977 0.980 0.983 0.986 0.988 0.990 0.992 0.993 0.994 0.995 0.997 0.998
0.9995
0.9995
1.00
*Average: Bone age within one year of chronologicage.
Retarded 0.680 0.690 0.700 0.709 0.718 0.728 0.738 0.747 0.756 0.765 0.773 0.779 0.786 0.794 0,800 0.807 0.812 0.816 0.819 0.821 0.823 0.827 0.832 0.839 0.845 0.852 0.860 0.869 0.880
l
Average*
0.695 0.702 0.709 0,716 0.723 0.731 0.739 0.746 0.752 0.761 0.769 0,777 0.784 0.791 0.795 0.800 0.804 0.812 0.818 0.827 0.834 0.843 0.853 0.863 0.876 0.890 0,902 0.914 0.927 0.938 0.948 0.958 0.968 0.973 0.976 0.980 0.982 0.985 0.987 0.989 0.991 0.993 0.994 0.995 0.996 0.998 1.00
l Advanced
0.670 0.676 0.683 0.689 0.696 0.703 0.709 0.715 0.720 0.728 0.734 0.741 0.747 0.753 0.758 0.763 0.767 0.776 0.786 0.800 0.809 0.818 0.828 0.839 0.850 0.863 0.875 0.890 0.905 0.918 0.930 0.943 0.958 0.967 0.971 0.976 0.980 0.983 0.985 0.988 0.990
442
Brief clinical and laboratory observations
3. Tanner JM, Whitehouse RH, Marshall WA, Healy M JR, and Goldstein H: Assessment of skeletal maturity and prediction of adult height: TW2 method, New York, 1975, Academic Press, Inc. 4. Roche AF, Wainer H, and Thissen D: The RWT method for the prediction of adult stature, Pediatrics 56:1026, 1975.
The Journal of Pediatrics March 1981
5. Zachmann M, Sobradillo B, Frank M, Frisch H, and Prader A: Bayley-Pinneau, Roche-Wainer-Thissen, and Tanner height predictions in normal children and in patients with various pathologic conditions, J PEDtA'rR 93:749, 1978. 6. Lenko HL: Prediction of adult height with various methods in Finnish children, Acta Paediatr Scand 68:85, 1979.