Auxology including sitting height | 3–6 monthly |
Plot BMI |
Bone age | Annually |
Discussion points | Schooling/employment—statementing? |
| Psychology assessment |
| Weight |
| Diarrhoea? |
| Eyes and mouth—?Sicca syndrome |
| (Consider faecal elastase/trial of Creon if loose stools/poor weight gain) |
| Hip pain/knee pain: consider MRI—?osteonecrosis |
| Fertility—if relevant/appropriate age |
Special points on examination | Pubertal assessment at each visit (testicular volume not a useful indicator of pubertal progression) |
| Palpation of thyroid |
| Check moles |
| Neurological examination |
| Fundoscopy (cataracts) |
| Blood pressure |
Echocardiogram | All patients who have had anthracyclines |
| Echocardiogram at end of treatment |
| (Request FS, LV function, septal motility) |
| ECG annually (QT interval) |
| 3 yearly if FS ⩾30%, annually if <30% |
Growth hormone status | Evaluate if persistent poor growth |
Glucose:insulin ratio | Annually—as increased risk of metabolic syndrome |
| GTT if abnormal |
Lipids | Fasting lipids annually |
Thyroid function | T4 and TSH annually |
| Replace thyroxine if TSH persistently elevated |
Gonadotrophins | LH, FSH, oestradiol/testosterone annually after 10 years of age |
| Consider pelvic USS in females; uterine size, endometrial thickness, Doppler studies |
| Semen studies in males as requested by patient |
| Ovarian failure may be reversible—trial off oestrogen for 6–8 weeks every 2 years recommended |
Evaluation of BMD | Annual PTH and vitamin D |
| DEXA at 2 years, then 3 yearly if concern (must correct for size) |
|