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Untoward events in patients treated with growth hormone in the USA
1Department of Pediatrics, Stanford University, Calif. 94305.
Insights
Growth hormone (GH) therapy in children has been linked to rare but serious side effects, including Creutzfeldt-Jakob disease and leukemia. Ongoing monitoring is crucial as GH use expands.
Area of Science:
- Pediatric Endocrinology
- Neurology
- Oncology
Background:
- Over 30,000 children in the USA have received growth hormone (GH) treatment since 1960.
- GH therapy is indicated for various growth-related conditions in pediatric patients.
Observation:
- Ten cases of Creutzfeldt-Jakob disease (CJD) have been associated with pituitary-derived GH in the USA.
- Ten cases of leukemia or preleukemia have been reported in children undergoing GH treatment.
- Eight of these leukemia cases occurred in patients with prior central nervous system tumors.
Findings:
- The use of pituitary-derived human growth hormone (hGH) has been linked to the transmission of CJD.
- GH treatment may be associated with an increased risk of leukemia, particularly in patients with pre-existing CNS conditions.
Implications:
- As indications for GH therapy broaden and dosages increase, vigilance for adverse events is necessary.
- Continued surveillance is essential to monitor for and understand potential GH-associated clinical events.
- Further research may be needed to elucidate the mechanisms linking GH to these rare adverse events.
Abstract:
Since 1960 more than 30,000 children have been treated with growth hormone (GH) in the USA. Ten cases of Creutzfeldt-Jakob disease have been associated with the use of GH purified from pituitaries in the USA, and more cases may appear in the future. Ten cases of leukemia or preleukemia have been reported in patients undergoing GH treatment in the US. Eight of these patients had previously diagnosed tumors of the central nervous system. As the indications for GH treatment broaden, and the dosages of GH increase, more unfavorable clinical events linked directly to the biological actions of GH can be expected to occur. Continued surveillance for clinically important GH-associated events is important.