title: Increase in haemoglobin concentrations in growth hormone deficient adults during human recombinant growth hormone replacement therapy.
abstract: OBJECTIVE
  Recombinant human growth hormone is being used increasingly in the treatment of GH deficiency in adults. In addition to erythropoietin, insulin-like growth factor-I (IGF-I) has been demonstrated to stimulate hematopoiesis in animals, especially rodents. We have determined the effect of growth hormone (GH) administration on haematopoiesis.
  
  
  METHODS
  Seventeen patients (10 males and 7 females; mean age 47 +/- 2 years; range 30-59) with biochemically proven adult-onset GH deficiency (GHD) were treated with human recombinant growth hormone (rhGH) as replacement therapy for more than 96 weeks in a dosage of 12.5 micrograms/kg/day (initial dosage during the first 4 weeks 6.25 micrograms/kg/day). The diagnosis of GHD had been confirmed using a standard arginine-infusion test (0.5 g/kg body weight). Blood samples were collected for safety and efficacy parameters before and during the GH treatment period.
  
  
  METHODS
  Routine methods were used for the haematological and biochemical measurements. IGF-I concentrations were measured, using a commercial RIA kit.
  
  
  RESULTS
  From week 36 and onwards, we observed a significant increase in individual haemoglobin (Hb) concentrations, especially in the male patients. Mean Hb in the male patients before treatment amounted to 9.1 +/- 0.2 mmol/l (range 8.1-10.5) and increased by 0.93 +/- 0.2 mmol/l (P < 0.05) after 120 weeks of rhGH replacement therapy. The mean Hb concentration in female patients before treatment was 8.1 +/- 0.1 mmol/l and an increase of 0.32 +/- 0.1 mmol/l (P < 0.05) was observed after 120 weeks. For all 17 patients the mean increase in Hb after 120 weeks was 0.73 +/- 0.2 mmol/l (P < 0.05). IGF-I concentrations also increased during therapy from 86 +/- 9 pg/l to 253 +/- 26 pg/l within 24 weeks (P < 0.05). No significant changes in leucocyte or platelet counts were found.
  
  
  CONCLUSIONS
  Long-term replacement therapy with rhGH in patients with adult-onset GHD induces a significant increase in Hb concentrations, while serum leucocyte and platelet counts do not change.
authors.affiliation: Department of Medicine, Erasmus University Rotterdam, The Netherlands.
authors.forename: S M
authors.initials: SM
authors.lastname: Ten Have
authors.forename: A J
authors.initials: AJ
authors.lastname: van der Lely
authors.forename: S W
authors.initials: SW
authors.lastname: Lamberts
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D003480:Cushing Syndrome / Q000097:blood / Q000601:surgery; D005260:Female; D013006:Growth Hormone / Q000172:deficiency* / Q000627:therapeutic use; D006441:Hemoglobin A / Q000378:metabolism*; D006801:Humans; D007016:Hypophysectomy; D007018:Hypopituitarism / Q000097:blood* / Q000188:drug therapy; D007334:Insulin-Like Growth Factor I / Q000032:analysis; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D010911:Pituitary Neoplasms / Q000097:blood / Q000601:surgery; D010976:Platelet Count; D015175:Prolactinoma / Q000097:blood / Q000601:surgery; D013997:Time Factors
chemical_list: D007334:Insulin-Like Growth Factor I; D013006:Growth Hormone; D006441:Hemoglobin A