Key result
GH therapy in adult ALL survivors is linked to lower glucose and reduced metabolic syndrome.
Why the study?
Does growth hormone therapy improve cardiovascular risk, cardiac function, physical activity, and quality of life in adult survivors of childhood acute lymphoblastic leukemia?
Cohort (n=29)
Open-label
No
Does growth hormone therapy improve cardiovascular risk, cardiac function, physical activity, and quality of life in adult survivors of childhood acute lymphoblastic leukemia?
Answers are grounded in this paper and cite their sources.
Long-term growth hormone therapy in adult survivors of childhood acute lymphoblastic leukemia reduces cardiovascular risk factors and metabolic syndrome prevalence without deteriorating cardiac function.
CONTEXT: Long-term data are missing in GH-treated acute lymphoblastic leukemia (ALL) patients. GH therapy may result in poorer outcome regarding cardiovascular (CV) and particularly cardiac effects than in patients with hypothalamic-pituitary disease. OBJECTIVE: Our objective was to evaluate GH therapy on CV risk, cardiac function, physical activity, and quality of life in ALL patients treated with cranial radiotherapy (18-24 Gy) and chemotherapy (anthracycline dose 120 mg/m2). DESIGN AND SETTING: We conducted a 5- and 8-yr open nonrandomized prospective study in a university hospital clinic. STUDY PARTICIPANTS: Two groups of GH-deficient ALL patients (aged 25 yr; range 19-32 yr) and matched population controls participated. INTERVENTIONS: One ALL group (n=16) received GH for 5 yr, and the other ALL group (n=13) did not receive GH therapy. MAIN OUTCOME MEASURES: We evaluated the prevalence of CV risk factors and metabolic syndrome (International Diabetes Federation consensus), cardiac function (echocardiography), and quality of life and physical activity questionnaires. RESULTS: In comparison with 8 yr without, 5 yr with GH therapy resulted in significant positive changes in plasma glucose (-0.5 vs. 0.6 mmol/liter, P=0.002), apolipoprotein B/apolipoprotein A1 ratio (-0.1 vs. 0.0, P=0.03), and high-density lipoprotein-cholesterol (0.20 vs.-0.01 mmol/liter, P=0.008) and a significant reduction in the prevalence of metabolic syndrome (P=0.008). No significant difference in the left-ventricular systolic function or in physical activity and quality of life was recorded before and after 5 or 8 yr, respectively (all P>0.3). CONCLUSION: GH therapy reduced the CV risk in this young ALL population but resulted in no clear benefit or deterioration in cardiac function.
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Follin et al. (2010) conducted a cohort in Acute Lymphoblastic Leukemia (ALL) survivors with GH deficiency (n=29). Growth hormone therapy vs. No growth hormone therapy was evaluated on Cardiovascular risk factors, metabolic syndrome, cardiac function, physical activity, and quality of life. Growth hormone therapy for 5 years in adult ALL survivors significantly improved plasma glucose (-0.5 vs 0.6 mmol/L; P=0.002) and reduced metabolic syndrome prevalence (P=0.008).
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