Key Points for This Section

Childhood cancer survivors may have late effects that affect the neuroendocrine system. Childhood cancer survivors who received a stem cell transplant with total-body irradiation (TBI) have an increased risk of growth disorders. Neuroendocrine late effects may be caused by treatment for certain childhood cancers.

Childhood cancer survivors may have late effects that affect the neuroendocrine system.

Neuroendocrine late effects may include the following:

• Low levels of pituitary hormones, including growth hormone.
• Early puberty (especially in females).
• Late puberty.
• Disorders of the hypothalamus.
• Pituitary gland problems.

Childhood cancer survivors who received a stem cell transplant with total-body irradiation (TBI) have an increased risk of growth disorders.

Their risk is affected as follows:

• Low levels of growth hormone are more likely if the survivor:
  • is female; or
  • received radiation therapy to the head before the transplant; or
  • received TBI in a single dose instead of divided doses; or
  • had graft-versus-host disease; or
  • received busulfan and cyclophosphamide.
• Adult height that is shorter than normal is more likely if the survivor:
  • is male; or
  • received the transplant at a young age; or
  • received TBI in a single dose instead of divided doses.

Neuroendocrine late effects may be caused by treatment for certain childhood cancers.

Treatment for these and other childhood cancers may cause neuroendocrine late effects:

• Acute lymphoblastic leukemia (ALL).
• Central nervous system (CNS) tumors.
• Lymphoma.

Glossary Terms

ALL. A fast-growing type of leukemia (blood cancer) in which too many lymphoblasts (immature white blood cells) are found in the blood and bone marrow. Also called ALL and acute lymphocytic leukemia.

An anticancer drug that belongs to the family of drugs called alkylating agents.

Central nervous system tumor. A tumor of the central nervous system (CNS), including brain stem glioma, craniopharyngioma, medulloblastoma, and meningioma. Also called central nervous system tumor.

An anticancer drug that belongs to the family of drugs called alkylating agents.

In medicine, a disturbance of normal functioning of the mind or body. Disorders may be caused by genetic factors, disease, or trauma.

The amount of medicine taken, or radiation given, at one time.

GVHD. A reaction of donated stem cells against the patient’s tissue. Also called GVHD.

One of many chemicals made by glands in the body. Hormones circulate in the bloodstream and control the actions of certain cells or organs. Some hormones can also be made in the laboratory.

The area of the brain that controls body temperature, hunger, and thirst.

Side effects of cancer treatment that appear months or years after treatment has ended. Late effects include physical and mental problems and second cancers.

Cancer that begins in cells of the immune system. There are two basic categories of lymphomas. One kind is Hodgkin lymphoma, which is marked by the presence of a type of cell called the Reed-Sternberg cell. The other category is non-Hodgkin lymphomas, which includes a large, diverse group of cancers of immune system cells. Non-Hodgkin lymphomas can be further divided into cancers that have an indolent (slow-growing) course and those that have an aggressive (fast-growing) course. These subtypes behave and respond to treatment differently. Both Hodgkin and non-Hodgkin lymphomas can occur in children and adults, and prognosis and treatment depend on the stage and the type of cancer.

Having to do with the interactions between the nervous system and the endocrine system. Neuroendocrine describes certain cells that release hormones into the blood in response to stimulation of the nervous system.

The main endocrine gland. It produces hormones that control other glands and many body functions, especially growth.

The use of high-energy radiation from x-rays, gamma rays, neutrons, protons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body near cancer cells (internal radiation therapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that travels in the blood to tissues throughout the body. Also called radiotherapy and irradiation.

A method of replacing immature blood-forming cells that were destroyed by cancer treatment. The stem cells are given to the person after treatment to help the bone marrow recover and continue producing healthy blood cells.

Radiation therapy to the entire body. It is usually followed by bone marrow or peripheral stem cell transplantation.