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. 1989 Feb;64(2):252–258. doi: 10.1136/adc.64.2.252

Suppressed spontaneous secretion of growth hormone in girls after treatment for acute lymphoblastic leukaemia.

C Moëll 1, S Garwicz 1, U Westgren 1, T Wiebe 1, K Albertsson-Wikland 1
PMCID: PMC1791878  PMID: 2494952

Abstract

The spontaneous secretion of growth hormone during a 24 hour period and the response of growth hormone to growth hormone releasing hormone was studied in 13 girls who had received treatment for acute lymphoblastic leukemia that included cranial irradiation with 20-24 Gy in 12-14 fractions. At the time of investigation the girls were at varying stages of puberty and had normal concentrations of thyroid hormones. The mean interval between the end of treatment and investigation was 4.6 years. The mean age at onset of the disease was 3.2 years and at investigation 10.7 years. The average attained height equalled -0.3 SD at onset, and -1.0 SD at the time of investigation. Secretion of growth hormone was substantially reduced compared with controls and did not increase during puberty. A prompt rise in growth hormone secretion was seen after injection of growth hormone releasing hormone, but the mean maximum growth hormone concentration was, however, only 25 mU/l. There was no correlation between the 24 hour secretion and growth hormone response to growth hormone releasing hormone, or the time since irradiation. These results confirm earlier work that suggested that girls who had received treatment for acute lymphoblastic leukaemia, that included cranial irradiation, have a comparative growth hormone insufficiency characterised by normal prepubertal growth and slow growth during puberty because of an inability to respond to the increased demands for growth hormone at that time.

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Selected References

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  1. Albertsson-Wikland K., Lannering B., Márky I., Mellander L., Wannholt U. A longitudinal study on growth and spontaneous growth hormone (GH) secretion in children with irradiated brain tumors. Acta Paediatr Scand. 1987 Nov;76(6):966–973. doi: 10.1111/j.1651-2227.1987.tb17273.x. [DOI] [PubMed] [Google Scholar]
  2. Albertsson-Wikland K., Rosberg S. Analyses of 24-hour growth hormone profiles in children: relation to growth. J Clin Endocrinol Metab. 1988 Sep;67(3):493–500. doi: 10.1210/jcem-67-3-493. [DOI] [PubMed] [Google Scholar]
  3. Bercu B. B., Shulman D., Root A. W., Spiliotis B. E. Growth hormone (GH) provocative testing frequently does not reflect endogenous GH secretion. J Clin Endocrinol Metab. 1986 Sep;63(3):709–716. doi: 10.1210/jcem-63-3-709. [DOI] [PubMed] [Google Scholar]
  4. Berglund G., Karlberg J., Marky I., Mellander L. A longitudinal study of growth in children with acute lymphoblastic leukemia. Acta Paediatr Scand. 1985 Jul;74(4):530–533. doi: 10.1111/j.1651-2227.1985.tb11023.x. [DOI] [PubMed] [Google Scholar]
  5. Berry D. H., Elders M. J., Crist W., Land V., Lui V., Sexauer A. C., Dickinson L. Growth in children with acute lymphocytic leukemia: a Pediatric Oncology Group study. Med Pediatr Oncol. 1983;11(1):39–45. doi: 10.1002/mpo.2950110109. [DOI] [PubMed] [Google Scholar]
  6. Blatt J., Bercu B. B., Gillin J. C., Mendelson W. B., Poplack D. G. Reduced pulsatile growth hormone secretion in children after therapy for acute lymphoblastic leukemia. J Pediatr. 1984 Feb;104(2):182–186. doi: 10.1016/s0022-3476(84)80989-0. [DOI] [PubMed] [Google Scholar]
  7. Brauner R., Prevot C., Roy M. P., Rappaport R. Growth, growth hormone secretion and somatomedin C after cranial irradiation for acute lymphoblastic leukemia. Acta Endocrinol Suppl (Copenh) 1986;279:178–182. doi: 10.1530/acta.0.112s178. [DOI] [PubMed] [Google Scholar]
  8. Clayton P. E., Shalet S. M., Morris-Jones P. H., Price D. A. Growth in children treated for acute lymphoblastic leukaemia. Lancet. 1988 Feb 27;1(8583):460–462. doi: 10.1016/s0140-6736(88)91246-9. [DOI] [PubMed] [Google Scholar]
  9. Gustafsson G., Garwicz S., Hertz H., Johanesson G., Jonmundsson G., Moe P. J., Salmi T., Seip M., Siimes M. A., Yssing M. A population-based study of childhood acute lymphoblastic leukemia diagnosed from July 1981 through June 1985 in the five Nordic countries. Incidence, patient characteristics and treatment results. Acta Paediatr Scand. 1987 Sep;76(5):781–788. doi: 10.1111/j.1651-2227.1987.tb10565.x. [DOI] [PubMed] [Google Scholar]
  10. Karlberg P., Taranger J. The somatic development of children in a swedish urban community. Acta Paediatr Scand Suppl. 1976;(258):1–148. [PubMed] [Google Scholar]
  11. Kirk J. A., Raghupathy P., Stevens M. M., Cowell C. T., Menser M. A., Bergin M., Tink A., Vines R. H., Silink M. Growth failure and growth-hormone deficiency after treatment for acute lymphoblastic leukaemia. Lancet. 1987 Jan 24;1(8526):190–193. doi: 10.1016/s0140-6736(87)90004-3. [DOI] [PubMed] [Google Scholar]
  12. Lannering B., Albertsson-Wikland K. Growth hormone release in children after cranial irradiation. Horm Res. 1987;27(1):13–22. doi: 10.1159/000180772. [DOI] [PubMed] [Google Scholar]
  13. Leiper A. D., Stanhope R., Kitching P., Chessells J. M. Precocious and premature puberty associated with treatment of acute lymphoblastic leukaemia. Arch Dis Child. 1987 Nov;62(11):1107–1112. doi: 10.1136/adc.62.11.1107. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Merriam G. R., Wachter K. W. Algorithms for the study of episodic hormone secretion. Am J Physiol. 1982 Oct;243(4):E310–E318. doi: 10.1152/ajpendo.1982.243.4.E310. [DOI] [PubMed] [Google Scholar]
  15. Moll G. W., Jr, Rosenfield R. L., Fang V. S. Administration of low-dose estrogen rapidly and directly stimulates growth hormone production. Am J Dis Child. 1986 Feb;140(2):124–127. doi: 10.1001/archpedi.1986.02140160042027. [DOI] [PubMed] [Google Scholar]
  16. Moëll C., Garwicz S., Westgren U., Wiebe T. Disturbed pubertal growth in girls treated for acute lymphoblastic leukemia. Pediatr Hematol Oncol. 1987;4(1):1–5. doi: 10.3109/08880018709141243. [DOI] [PubMed] [Google Scholar]
  17. Romshe C. A., Zipf W. B., Miser A., Miser J., Sotos J. F., Newton W. A. Evaluation of growth hormone release and human growth hormone treatment in children with cranial irradiation-associated short stature. J Pediatr. 1984 Feb;104(2):177–181. doi: 10.1016/s0022-3476(84)80988-9. [DOI] [PubMed] [Google Scholar]
  18. Sainsbury C. P., Newcombe R. G., Hughes I. A. Weight gain and height velocity during prolonged first remission from acute lymphoblastic leukaemia. Arch Dis Child. 1985 Sep;60(9):832–836. doi: 10.1136/adc.60.9.832. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Schuler D., Gács G., Révész T., Koós R., Keleti J. Hypophysenfunktion und Wachstum bei Kindern unter Leukämiebehandlung. Monatsschr Kinderheilkd. 1980 Dec;128(12):773–775. [PubMed] [Google Scholar]
  20. Shalet S. M., Beardwell C. G., Aarons B. M., Pearson D., Jones P. H. Growth impairment in children treated for brain tumours. Arch Dis Child. 1978 Jun;53(6):491–494. doi: 10.1136/adc.53.6.491. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Shalet S. M., Beardwell C. G., Twomey J. A., Jones P. H., Pearson D. Endocrine function following the treatment of acute leukemia in childhood. J Pediatr. 1977 Jun;90(6):920–923. doi: 10.1016/s0022-3476(77)80559-3. [DOI] [PubMed] [Google Scholar]
  22. Shalet S. M., Price D. A., Beardwell C. G., Jones P. H., Pearson D. Normal growth despite abnormalities of growth hormone secretion in children treated for acute leukemia. J Pediatr. 1979 May;94(5):719–722. doi: 10.1016/s0022-3476(79)80137-7. [DOI] [PubMed] [Google Scholar]
  23. Swift P. G., Kearney P. J., Dalton R. G., Bullimore J. A., Mott M. G., Savage D. C. Growth and hormonal status of children treated for acute lymphoblastic leukaemia. Arch Dis Child. 1978 Nov;53(11):890–894. doi: 10.1136/adc.53.11.890. [DOI] [PMC free article] [PubMed] [Google Scholar]

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