Outcomes of Growth Hormone Replacement Therapy in Survivors of Childhood Acute Lymphoblastic Leukemia

Leung, Wing; Rose, Susan R.; Zhou, Yinmei; Hancock, Michael L.; Burstein, Stephen; Schriock, Elizabeth A.; Lustig, Robert H.; Danish, Robert K.; Evans, William E.; Hudson, Melissa M.; Pui, Ching‐Hon

doi:10.1200/jco.2002.09.142

Cited by 87 publications

(47 citation statements)

References 29 publications

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“…In our study height loss from AL diagnosis to GHD diagnosis was greater in girls and in patients younger than 5 years at the time of cranial irradiation. This is in line with other data indicating that girls 17,23 and younger patients 1,7 lose more s.d.s./Z before the start of GH treatment. Conversely, in the study of Sanders et al, 1 boys were shorter than girls at the last evaluation before GH therapy.…”

Section: Discussionsupporting

confidence: 82%

“…in Leung et al 17 and þ 0.59Z in our study; (2) a maintained height s.d.s./Z-score 15,16,23 and (3) 'only' a height s.d.s./Z-score loss reduction. 1,2,24 In our study, the overall recovery effect from start of GH therapy to FH was stronger in girls.…”

Section: Response To Gh Treatmentmentioning

confidence: 77%

“…ranged from À1.2 to À2 1,2,16,17,23,24 (Table 3). In our study height loss from AL diagnosis to GHD diagnosis was greater in girls and in patients younger than 5 years at the time of cranial irradiation.…”

Section: Discussionmentioning

confidence: 99%

“…Treatment duration was 3-4 years in most studies 6,7,15,16 with 44 years 17,23 or o1 year 25 of GH substitution in some others. Treatment duration was found to be a predictive factor for height loss in the study of Frisk et al 7 In our study in which GH substitution was stopped when growth velocity was o1 cm/year (it was assumed that there would be no further benefit from continuing the treatment in these patients), there seemed to be a trend towards better height growth in children treated for longer than 2 years.…”

Section: Response To Gh Treatmentmentioning

confidence: 99%

“…3,6,[9][10][11][12][13][14] By contrast, only a few studies have evaluated the impact of GH replacement therapy on growth rate and FH in these children. 1,2,7,[15][16][17] A better understanding of the factors influencing response to GH will allow the identification of patients who can benefit from appropriate hormonal replacement therapy. This is important given that currently fewer than half of the GH deficiency (GHD) children after HSCT or CI receive GH therapy.…”

Section: Introductionmentioning

confidence: 99%

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Growth hormone treatment impact on growth rate and final height of patients who received HSCT with TBI or/and cranial irradiation in childhood: a report from the French Leukaemia Long-Term Follow-Up Study (LEA)

Isfan

Kanold

Merlin

et al. 2011

Bone Marrow Transplant

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The literature contains a substantial amount of information about factors that adversely influence the linear growth in up to 85% of patients undergoing haematopoietic SCT (HSCT) with TBI and/or cranial irradiation (CI) for acute leukaemia (AL). By contrast, only a few studies have evaluated the impact of growth hormone (GH) therapy on growth rate and final height (FH) in these children. We evaluated growth rates during the preand post-transplant periods to FH in a group of 25 children treated with HSCT (n ¼ 22), TBI (n ¼ 21) or/and CI (n ¼ 8) for AL and receiving GH therapy. At the start of GH treatment, the median height Z-score was À2.19 (À3.95 to 0.02), significantly lower than at AL diagnosis (Po0.001). Overall height gain from start of GH treatment to FH was 0.59Z (À2.72 to 2.93) with a median height Z-score at FH of À1.35 (À5.35 to 0.27). This overall height gain effect was greater in girls than in boys (P ¼ 0.04). The number of children with heights in the reference population range was greater after than before GH therapy (P ¼ 0.07). At FH the GVHD and GH treatments lasting o2 years were associated with shorter FH (P ¼ 0.02 and 0.05). We found a measurable beneficial effect of GH treatment on growth up to FH.

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Section: Discussionsupporting

confidence: 82%

Section: Response To Gh Treatmentmentioning

confidence: 77%

Section: Discussionmentioning

confidence: 99%

Section: Response To Gh Treatmentmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Growth hormone treatment impact on growth rate and final height of patients who received HSCT with TBI or/and cranial irradiation in childhood: a report from the French Leukaemia Long-Term Follow-Up Study (LEA)

Isfan

Kanold

Merlin

et al. 2011

Bone Marrow Transplant

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Erratum: “Review: An overview about the structure‐function relationship of marine sulfated homopolysaccharides with regular chemical structures” biopolymers 91(8), 601–609, (2009)

Pomin

2010

Biopolymers

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Growth hormone deficiency after chemotherapy for acute lymphoblastic leukemia in children who have not received cranial radiation

Haddy

Mosher

Nunez

et al. 2005

Pediatric Blood & Cancer

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Chemotherapy-related growth failure is a significant problem in children with acute lymphoblastic leukemia (ALL) and other childhood cancers. Growth impairment after cranial radiation (CR) can result in diminished adult height, but growth failure following chemotherapy without CR is usually followed by catch-up growth and normal adult height.1 A retrospective review of 347 ALL survivors registered in our Long Term Follow Up (LTFU) Clinic, since 1997 revealed that 109 had received CR; 3, total body irradiation (TBI); and 235, neither CR nor TBI. For patients whose growth velocity slowed, growth hormone (GH) levels and pediatric endocrinology referrals were obtained. Among the 112 ALL survivors who had received some form of CR, 5 had significant growth failure with growth hormone deficiency (GHD). Among the 235 ALL survivors treated with chemotherapy without CR, 2 were diagnosed with growth failure and GHD. We report the two survivors of childhood ALL treated with chemotherapy without CR who required GH replacement due to absence of catch-up growth. A 15-year-old boy and a 12-year-old girl, off therapy for 9 and 6 years, respectively, were evaluated for decreased growth velocity and failure of catch-up growth. Peak GH responses to stimulation using arginine and clonidine were 3.4 and 3.0 ng/ml, respectively (normal >10 ng/ml). Other causes of growth failure were ruled out, and GH replacement therapy was instituted. Their chemotherapy had included methotrexate, 6 mercaptopurine, vincristine, adriamycin, cyclophosphamide, L-asparaginase, dexamethasone, cytarabine, 6 thioguanine, and intrathecal methotrexate. The growth of all children treated with intensive chemotherapy, regardless of whether CR was administered, should be closely monitored with measurement of standing height at 6 months intervals until growth is complete.

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Outcomes of Growth Hormone Replacement Therapy in Survivors of Childhood Acute Lymphoblastic Leukemia

Abstract: This study suggests that GH replacement therapy is safe and efficacious for the correction of GH deficiency in survivors of childhood ALL.

Cited by 87 publications

References 29 publications

Growth hormone treatment impact on growth rate and final height of patients who received HSCT with TBI or/and cranial irradiation in childhood: a report from the French Leukaemia Long-Term Follow-Up Study (LEA)

Growth hormone treatment impact on growth rate and final height of patients who received HSCT with TBI or/and cranial irradiation in childhood: a report from the French Leukaemia Long-Term Follow-Up Study (LEA)

Erratum: “Review: An overview about the structure‐function relationship of marine sulfated homopolysaccharides with regular chemical structures” biopolymers 91(8), 601–609, (2009)

Growth hormone deficiency after chemotherapy for acute lymphoblastic leukemia in children who have not received cranial radiation

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