Effects of cytotoxic therapy on hypothalamic-pituitary-adrenal axis response to insulin-induced hypoglycemia in patients with a variety of acute leukemias.
The effect of cytotoxic therapy (including cytosine-arabinoside and thioguanine) on the adrenal response to insulin-induced hypoglycemia has been investigated in 15 newly diagnosed patients with an acute form of leukemia. Hypoglycemia was induced with crystalline insulin (0.15 U kg-1). Cortisol, growth hormone and prolactin were determined by radioimmunoassay at 0, 30, 60, 90 and 120 min during the insulin-tolerance test and also before and after the completion of the therapy. There was a significant impairment of a cortisol response after the completion of the cytotoxic therapy, while no significant changes could be detected in growth hormone and prolactin response. It is concluded that either cortisol synthesis or release mechanism was compromised by the cytotoxic therapy and/or metabolic derangements brought about therewith.
D000208:Acute Disease; D000328:Adult; D000970:Antineoplastic Agents / Q000009:adverse effects*; D001786:Blood Glucose / Q000378:metabolism*; D005260:Female; D013006:Growth Hormone / Q000032:analysis; D006801:Humans; D006854:Hydrocortisone / Q000032:analysis; D007030:Hypothalamo-Hypophyseal System / Q000187:drug effects*; D007328:Insulin / Q000494:pharmacology*; D007938:Leukemia / Q000188:drug therapy / Q000378:metabolism*; D008297:Male; D010913:Pituitary-Adrenal System / Q000187:drug effects*
D000970:Antineoplastic Agents; D001786:Blood Glucose; D007328:Insulin; D013006:Growth Hormone; D006854:Hydrocortisone