Long-term endocrine and metabolic outcomes and growth and body mass index dynamics among survivors of childhood hematologic malignancies

Advances in the treatment of childhood hematologic malignancies have markedly improved survival rates, bringing long-term treatment-related complications increasingly into focus. The aim of this study was to evaluate the long-term endocrine and metabolic effects of antineoplastic therapy, together with longitudinal changes in growth and body mass index (BMI). In this retrospective longitudinal study, 22 patients treated for childhood hematologic malignancies were enrolled, all of whom underwent comprehensive endocrinological assessment. Growth and BMI parameters were analysed at four predefined time points using standard deviation scores (SDS). Data were analysed using descriptive statistical methods (Microsoft Excel). The median age was 4.4 years at diagnosis, 7.6 years at the completion of treatment, and 10.9 years at the time of evaluation. The median follow-up duration was 9.6 years. At least two endocrine and metabolic abnormalities were identified in 63.6% of patients, while 40.9% presented with three or more abnormalities. The most frequent disturbances involved bone and mineral metabolism, with vitamin D deficiency observed in 63.6% of patients, hypocalcaemia in 36.4%, and secondary hyperparathyroidism in 31.8%. Dyslipidaemia was present in 36.4% of patients. Overweight/obesity was identified in 36.4%, whereas hypertension and pubertal disorders were each observed in 22.7% of cases. No thyroid hormone abnormalities were detected. Between diagnosis and the completion of chemotherapy, the median height SDS decreased by 0.13, whereas the median BMI SDS increased by 0.91; 59.1% of patients exhibited an increase of at least 0.5 SDS in BMI. During the follow-up period (n = 18), partial catch-up growth was observed (median +0.59 SDS), while the increase in BMI persisted (median +0.79 SDS). These findings indicate that treatment of childhood hematologic malignancies is associated with cumulative endocrine and metabolic disturbances, transient impairment of growth, and a sustained increase in BMI, which may contribute to an elevated long-term cardiovascular risk and underscore the importance of structured long-term follow-up.