Final Height in Girls with Central Idiopathic Precocious Puberty Treated with Gonadotropin-Releasing Hormone Analog and Oxandrolone

Vottero, Alessandra; Pedori, S.; Verna, Marta; Pagano, Blandina; Cappa, Marco; Loche, Sandro; Bernasconi, Sergio; Ghizzoni, Lucia

doi:10.1210/jc.2005-1693

Cited by 37 publications

(8 citation statements)

References 32 publications

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“…1E). The median time to engraftment (>500 neutrophils/AL blood) was 14 days (range, 10-28) in the allogeneic LHRH group compared with 16 days (range, [10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27] for the non -LHRH-A -treated group. In the autologous setting, the median time to engraftment for LHRH-treated patients was 12 days (10-15) compared with 13 days (10-32) for the non -LHRH-A -treated patients.…”

Section: Resultsmentioning

confidence: 97%

“…Temporary chemical castration can be achieved using luteinizing hormone -releasing hormone analogues (LHRH-A); widely used in the clinic to treat numerous endocrinologic disorders such as endometriosis (16), precocious puberty (17), prostate cancer (18), and breast cancer (19). Pretreatment using these analogues has also been tested in order to protect against chemotherapy-induced sterility in both males and females undergoing HSCT (20).…”

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confidence: 99%

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Enhanced Immune System Regeneration in Humans Following Allogeneic or Autologous Hemopoietic Stem Cell Transplantation by Temporary Sex Steroid Blockade

Sutherland

Spyroglou

Muirhead

et al. 2008

Clinical Cancer Research

116

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Purpose: To determine if temporarily blocking sex steroids prior to stem cell transplantation can increase thymus function and thus enhance the rate of Tcell regeneration. Experimental Design: This was a pilot study of luteinizing hormone^releasing hormone agonist (LHRH-A) goserelin given 3 weeks prior to allogeneic or autologous hemopoietic stem cell transplantation and administered up to 3 months posttransplantation. Patients (with or without LHRH-A administration) were assessed from 1week to 12 months posttransplantation for multiple immunologic variables by flow cytometry (particularly naI« ve T cells), quantitative PCR to assess T-cell receptor excision circle levels (as a correlate of thymus function), CDR3 length analysis to determine the variability of the TCR repertoire, and in vitro assays to determine functional T cell responses. Results: LHRH-A administration prior to stem cell transplantation significantly increased neutrophil and lymphocyte numbers within the first month of posttransplantation. Most importantly, total and naI« ve CD4 + T cell regeneration together with T-cell receptor excision circle production, T cell repertoire regeneration, and peripheral T cell function were also significantly enhanced at multiple time points posttransplant. In addition, an increase in disease-free survival (P = 0.04) was seen in the autologous setting. Although LHRH-A administration increased T cell responses in vitro, it did not exacerbate graft-versus-host disease in the allogeneic setting. Conclusions: This study provides an important new approach to the improvement of immune reconstitution in patients undergoing hemopoietic stem cell transplantation and may have generic applications in manyTcell^based disorders.

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Section: Resultsmentioning

confidence: 97%

mentioning

confidence: 99%

Enhanced Immune System Regeneration in Humans Following Allogeneic or Autologous Hemopoietic Stem Cell Transplantation by Temporary Sex Steroid Blockade

Sutherland

Spyroglou

Muirhead

et al. 2008

Clinical Cancer Research

116

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“…A small nonrandomized study of ten patients receiving oxandrolone in addition to GnRHa for severe deceleration of growth velocity during treatment for CPP suggested that this combination might improve adult height, compared with GnRHa alone. However, larger randomized studies have not been performed [48]. …”

Section: Adjunctive Treatmentsmentioning

confidence: 99%

Central Precocious Puberty: Update on Diagnosis and Treatment

2015

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Central precocious puberty (CPP) is characterized by the same biochemical and physical features as normally timed puberty but occurs at an abnormally early age. Most cases of CPP are seen in girls, in whom it is usually idiopathic. In contrast, ∼50 % of boys with CPP have an identifiable cause. The diagnosis of CPP relies on clinical, biochemical, and radiographic features. Untreated, CPP has the potential to result in early epiphyseal fusion and a significant compromise in adult height. Thus, the main goal of therapy is preservation of height potential. The gold-standard treatment for CPP is go-nadotropin-releasing hormone (GnRH) analogs (GnRHa). Numerous preparations with a range of delivery systems and durations of action are commercially available. While the outcomes of patients treated for CPP have generally been favorable, more research about the psychological aspects, optimal monitoring, and long-term effects of all forms of GnRHa treatment is needed. Several potential therapeutic alternatives to GnRHa exist and await additional investigation.

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“…The results suggested that the low height velocity on GnRHa can be prevented by low-dose estrogen without undue acceleration of bone age (LoE 2), but long-term results have not been reported. Second, the combination of a GnRHa with an anabolic steroid was investigated in two studies with an apparently positive effect on AH compared with matched controls ( 34 , 35 ) (LoE 3), but since then no more data have been presented. Third, rhGH can be added, which will be discussed in paragraph 2.2.5…”

Section: The Effect and Safety Of A Gnrh Analogue In Children With A Low Predicted Adult Heightmentioning

confidence: 99%

Should Skeletal Maturation Be Manipulated for Extra Height Gain?

Wit

2021

Front. Endocrinol.

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Skeletal maturation can be delayed by reducing the exposure to estrogens, either by halting pubertal development through administering a GnRH analogue (GnRHa), or by blocking the conversion of androgens to estrogens through an aromatase inhibitor (AI). These agents have been investigated in children with growth disorders (off-label), either alone or in combination with recombinant human growth hormone (rhGH). GnRHa is effective in attaining a normal adult height (AH) in the treatment of children with central precocious puberty, but its effect in short children with normal timing of puberty is equivocal. If rhGH-treated children with growth hormone deficiency or those who were born small-for-gestational age are still short at pubertal onset, co-treatment with a GnRHa for 2-3 years increases AH. A similar effect was seen by adding rhGH to GnRHa treatment of children with central precocious puberty with a poor AH prediction and by adding rhGH plus GnRHa to children with congenital adrenal hyperplasia with a poor predicted adult height on conventional treatment with gluco- and mineralocorticoids. In girls with idiopathic short stature and relatively early puberty, rhGH plus GnRHa increases AH. Administration of letrozole to boys with constitutional delay of growth puberty may increase AH, and rhGH plus anastrozole may increase AH in boys with growth hormone deficiency or idiopathic short stature, but the lack of data on attained AH and potential selective loss-of-follow-up in several studies precludes firm conclusions. GnRHas appear to have a good overall safety profile, while for aromatase inhibitors conflicting data have been reported.

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Final Height in Girls with Central Idiopathic Precocious Puberty Treated with Gonadotropin-Releasing Hormone Analog and Oxandrolone

Abstract: Combined GnRHa and Ox therapy is a viable treatment option for children with CPP and marked growth deceleration during treatment with GnRHa alone.

Cited by 37 publications

References 32 publications

Enhanced Immune System Regeneration in Humans Following Allogeneic or Autologous Hemopoietic Stem Cell Transplantation by Temporary Sex Steroid Blockade

Enhanced Immune System Regeneration in Humans Following Allogeneic or Autologous Hemopoietic Stem Cell Transplantation by Temporary Sex Steroid Blockade

Central Precocious Puberty: Update on Diagnosis and Treatment

Should Skeletal Maturation Be Manipulated for Extra Height Gain?

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