From the Guidelines
Tanner staging should be performed every 6 months in children with chronic myeloid leukemia until they reach Tanner's stage 5 to monitor for pubertal delay and other potential endocrine alterations 1.
Importance of Tanner Staging
Tanner staging is a crucial tool for assessing the physical development of children and adolescents during puberty. It consists of five stages that describe the progression of secondary sexual characteristics in both males and females. For males, Tanner staging evaluates genital development and pubic hair growth, while for females, it assesses breast development and pubic hair growth.
Application in Clinical Practice
Healthcare providers use Tanner staging during routine pediatric examinations to monitor normal development, identify early or delayed puberty, and guide clinical decisions. The timing of progression through these stages varies widely among individuals, with girls typically beginning puberty between ages 8-13 and boys between 9-14. Understanding a child's Tanner stage helps clinicians provide appropriate anticipatory guidance to patients and families regarding normal developmental changes and address any concerns about growth or development.
Monitoring for Endocrine Alterations
In the context of chronic myeloid leukemia, regular Tanner staging is essential for monitoring potential endocrine alterations, such as pubertal delay, growth deceleration, and other hormonal imbalances 1. The international pediatric chronic myeloid leukemia expert panel recommends performing Tanner staging every 6 months until the child reaches Tanner's stage 5. This approach enables early identification of potential issues and prompt referral to endocrinology specialists if needed.
Additional Considerations
When interpreting Tanner staging results, clinicians should consider the child's overall health status, including any underlying medical conditions or treatments that may impact growth and development. For example, children with pituitary adenomas may require more frequent monitoring of their Tanner stage, as well as assessment of other anterior pituitary hormones 1. By prioritizing regular Tanner staging and comprehensive monitoring, healthcare providers can optimize the care of children with chronic myeloid leukemia and promote the best possible outcomes in terms of morbidity, mortality, and quality of life.
From the Research
Definition and Purpose of Tanner Staging
- Tanner staging is a scale of physical development in children, adolescents, and adults that defines physical measurements of development based on external primary and secondary sex characteristics, such as the size of the breasts, genitals, testicular volume, and development of pubic hair 2.
- The purpose of Tanner staging is to assess the physical development and maturation of individuals, particularly during puberty 3.
Methods of Assessing Tanner Staging
- Tanner staging can be assessed through self-reporting, parent reporting, or clinical evaluation by a healthcare professional 4.
- Self-rated Tanner staging and simple questions regarding pubertal onset and development are positively associated with adolescent gonadal hormone concentrations in serum measured by mass spectrometry 2.
- Endocrine markers in urine and saliva may provide an objective, sensitive, and non-invasive method for assessing development and can complement Tanner staging 3.
Relationship Between Tanner Staging and Other Measures
- Tanner staging is associated with measures of body composition, blood pressure, and insulin in black girls 5.
- Breast development is a better predictor of body composition and fasting insulin than pubic hair development or a composite index of pubertal staging 5.
- Tanner stage-adjusted height-for-age charts can account for differences in growth patterns and timing due to variations in normal pubertal development, pubertal disorders, and race/ethnicity 6.
Applications of Tanner Staging
- Tanner staging can be used in large community-based studies where physical examination is not feasible 2.
- Tanner staging can be used in clinical management of children with pubertal timing variations 6.
- The Pubertal Development Scale (PDS) is a reliable and generally tracks with Tanner staging, and can be used in child and adolescent research 4.