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dc.contributor.authorBrennan, B M
dc.contributor.authorRahim, A
dc.contributor.authorMackie, E M
dc.contributor.authorEden, Tim O B
dc.contributor.authorShalet, Stephen M
dc.date.accessioned2010-02-12T12:22:47Z
dc.date.available2010-02-12T12:22:47Z
dc.date.issued1998-06
dc.identifier.citationGrowth hormone status in adults treated for acute lymphoblastic leukaemia in childhood. 1998, 48 (6):777-83 Clin. Endocrinol. (Oxf)en
dc.identifier.issn0300-0664
dc.identifier.pmid9713568
dc.identifier.doi10.1046/j.1365-2265.1998.00438.x
dc.identifier.urihttp://hdl.handle.net/10541/91931
dc.description.abstractOBJECTIVE: Growth hormone status was assessed in a cohort of 32 (16 male) adults who had received cranial irradiation (XRT) in childhood as part of their treatment for acute lymphoblastic leukaemia (ALL) and compared with 35 age matched young adults (18 male). DESIGN: Height and weight were measured in all subjects and the heights of the patients at XRT were obtained from their case notes. Each patient and control underwent two provocative tests of growth hormone (GH) secretion using insulin (0.2 IU/kg body weight) and arginine (20 g/m2). Basal serum insulin like growth factor-1 (IGF-1) and IGFBP-3 (binding protein-3) concentrations were also measured. RESULTS: The patient group had a significantly lower peak GH response to both provocative tests (P < 0.01), and lower IGF-1 and IGFBP-3 levels compared with the normal controls (P < 0.01). Nine of the patient group were severely GH deficient (peak GH response < 9 mU/l to both provocative agents) and a further 12 patients were GH insufficient (peak GH response < 20 mU/l to both tests with at least one peak GH response > 9 mU/l). Overall a significant median change in height from XRT to final height of -0.5 SDS was found which was even greater in the severely GH deficient group (median change in height of -2.1 SDS). CONCLUSION: These data suggest that a significant proportion of adults treated with cranial XRT in childhood with irradiation doses between 18-25 Gy, as part of their treatment for ALL, are severely GH deficient now and should be considered for GH replacement. Changes in GH secretion evolve with time following irradiation-induced damage to the hypothalamic-pituitary axis; therefore long-term surveillance will be required in those remaining patients, in whom GH status is considered currently to be insufficient or even normal.
dc.language.isoenen
dc.subjectPrecursor Cell Lymphoblastic Leukaemia-Lymphomaen
dc.subject.meshAdolescent
dc.subject.meshAdult
dc.subject.meshArginine
dc.subject.meshFemale
dc.subject.meshFollow-Up Studies
dc.subject.meshGrowth Disorders
dc.subject.meshGrowth Hormone
dc.subject.meshHumans
dc.subject.meshInsulin
dc.subject.meshMale
dc.subject.meshPituitary Irradiation
dc.subject.meshPrecursor Cell Lymphoblastic Leukemia-Lymphoma
dc.titleGrowth hormone status in adults treated for acute lymphoblastic leukaemia in childhood.en
dc.typeArticleen
dc.contributor.departmentDepartment of Paediatric Oncology, Royal Manchester Children's Hospital, UK.en
dc.identifier.journalClinical Endocrinologyen
html.description.abstractOBJECTIVE: Growth hormone status was assessed in a cohort of 32 (16 male) adults who had received cranial irradiation (XRT) in childhood as part of their treatment for acute lymphoblastic leukaemia (ALL) and compared with 35 age matched young adults (18 male). DESIGN: Height and weight were measured in all subjects and the heights of the patients at XRT were obtained from their case notes. Each patient and control underwent two provocative tests of growth hormone (GH) secretion using insulin (0.2 IU/kg body weight) and arginine (20 g/m2). Basal serum insulin like growth factor-1 (IGF-1) and IGFBP-3 (binding protein-3) concentrations were also measured. RESULTS: The patient group had a significantly lower peak GH response to both provocative tests (P < 0.01), and lower IGF-1 and IGFBP-3 levels compared with the normal controls (P < 0.01). Nine of the patient group were severely GH deficient (peak GH response < 9 mU/l to both provocative agents) and a further 12 patients were GH insufficient (peak GH response < 20 mU/l to both tests with at least one peak GH response > 9 mU/l). Overall a significant median change in height from XRT to final height of -0.5 SDS was found which was even greater in the severely GH deficient group (median change in height of -2.1 SDS). CONCLUSION: These data suggest that a significant proportion of adults treated with cranial XRT in childhood with irradiation doses between 18-25 Gy, as part of their treatment for ALL, are severely GH deficient now and should be considered for GH replacement. Changes in GH secretion evolve with time following irradiation-induced damage to the hypothalamic-pituitary axis; therefore long-term surveillance will be required in those remaining patients, in whom GH status is considered currently to be insufficient or even normal.


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