Reduced pulsatile growth hormone secretion in children after therapy for acute lymphoblastic leukemia
Abstract
Basal growth hormone levels were measured every 20 minutes over 24 hours in eight long-term survivors of acute lymphoblastic leukemia and in 13 age- and pubertal stage-matched normal children. Among the patients, the median total basal growth hormone output (AUC) was 43 units, compared with 341 units in the normal control group (P less than 0.001). In the patients, mean pulse amplitude (6.9 ng/ml) and frequency (4.6) over 24 hours also were reduced, compared with the control values (32 ng/ml and 8.5, P less than 0.001 and P less than 0.05, respectively). In addition, normal children secreted more GH at night (median AUC 280) than during the day (113, P less than 0.001). However, this diurnal pattern was absent in three of the patients studied. These data suggest that perturbations of spontaneous pulsatile GH secretion are common after standard therapy for ALL and may be a sensitive means of detecting therapy-related neuroendocrine damage. Blunting of spontaneous pulsatile GH secretion may contribute to the abnormalities in growth seen in children with ALL.
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Overnight (12 h) spontaneous GH secretion has been found to be lower than normal in some children after cranial irradiation and can indicate a subtle GH defect.
“Overnight (12 h) spontaneous GH secretion has been found to be lower than normal in some children after cranial irradiation (another example of hypothalamic injury), and can indicate a subtle GH defect [54].”
From Update of Endocrine Dysfunction following Pediatric Traumatic Brain Injury (2015) · cites this paper as [54]
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Diagnosis of Hidden Central Hypothyroidism in Survivors of Childhood Cancer<sup>1</sup>
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Update of Endocrine Dysfunction following Pediatric Traumatic Brain Injury
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“Overnight (12 h) spontaneous GH secretion has been found to be lower than normal in some children after cranial irradiation (another example of hypothalamic injury), and can indicate a subtle GH defect [54].”
BackgroundCranial irradiation and central hypothyroidism
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- Authors
- Blatt, J., Bercu, B. B., Christopher Gillin, J., Mendelson, W. B., & Poplack, D. G.
- Corresponding author
- Poplack, David G.
- ORCID
- Blatt, Julie
- Venue
- The Journal of Pediatrics
- Publisher
- Elsevier BV
- Published
- 1984-02
- Volume
- 104
- Issue
- 2
- Pages
- 182-186
- ISSN
- 0022-3476 (ISSN-L)
- OpenAlex
- W2086814988
- Cited by
- 186
- References
- 19
- Citations by year
- 2022: 2 · 2021: 2 · 2018: 3 · 2017: 1 · 2016: 2 · 2015: 4 · 2014: 2 · 2013: 3 · 2012: 1
- FWCI
- 10.83
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Pediatrics (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Growth Hormone and Insulin-like Growth Factors
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Pituitary Gland Disorders and Treatments
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Acute Lymphoblastic Leukemia research
- Keywords
- growth hormone secretion, pulsatile secretion, acute lymphoblastic leukemia, childhood cancer survivors, neuroendocrine toxicity, diurnal variation, abnormal growth, chemotherapy side effects
- MeSH terms
- Adolescent, Adult, Antineoplastic Combined Chemotherapy Protocols, Brain, Child, Circadian Rhythm, Female, Humans, Injections, Spinal, Leukemia, Lymphoid, Male, Methotrexate, Growth Hormone
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