Outcomes of growth hormone replacement therapy in survivors of childhood acute lymphoblastic leukemia.
OBJECTIVE
Little is known about the long-term efficacy or adverse effects of growth hormone (GH) replacement therapy in survivors of childhood acute lymphoblastic leukemia (ALL) who have GH deficiency. We investigated the adult height of patients who had received GH and estimated their risk of leukemia relapse or development of a second malignancy.


METHODS
Of 910 patients treated for ALL at a single institution, 47 had received GH replacement therapy. The linear growth of these 47 patients was retrospectively evaluated. Their risk of leukemia relapse or second malignancy was compared with that of survivors who did not undergo GH therapy.


RESULTS
The median height SD score at the start of GH therapy had decreased by 1.0 since the time of diagnosis of ALL. After a median duration of 4.5 years of GH therapy, adult height SD scores improved and approached height SD scores at the time of diagnosis of ALL. The median adult height for male patients was 173.2 cm (range, 157 to 191.9 cm), and for female patients, it was 158.1 cm (range, 141 to 168 cm). None of the patients developed adverse effects requiring discontinuation of GH treatment. At the 7-year and 11-year landmarks in continuous hematologic remission, there was no statistical evidence that GH therapy was associated with leukemia relapse or development of a second malignancy.


CONCLUSIONS
This study suggests that GH replacement therapy is safe and efficacious for the correction of GH deficiency in survivors of childhood ALL.
Leung
Wing
W
After Completion of Therapy Program and the Department of Hematology-Oncology, St Jude Children's Research Hospital, Memphis, TN 38105-2794, USA. wing.leung@stjude.org
Rose
Susan R
SR
Zhou
Yinmei
Y
Hancock
Michael L
ML
Burstein
Stephen
S
Schriock
Elizabeth A
EA
Lustig
Robert
R
Danish
Robert K
RK
Evans
William E
WE
Hudson
Melissa M
MM
Pui
Ching-Hon
CH
D000293:Adolescent; D001827:Body Height / Q000187:drug effects*; D002648:Child; D005260:Female; D006130:Growth Disorders / Q000188:drug therapy* / Q000209:etiology*; D019382:Human Growth Hormone / Q000008:administration & dosage / Q000009:adverse effects / Q000172:deficiency* / Q000627:therapeutic use*; D006801:Humans; D015994:Incidence; D008297:Male; D016609:Neoplasms, Second Primary / Q000453:epidemiology; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000453:epidemiology / Q000628:therapy*; D012008:Recurrence; D012189:Retrospective Studies; D013714:Tennessee / Q000453:epidemiology
D019382:Human Growth Hormone