[Growth hormone therapy and leukemia]

In this literature study the possible correlation between GH-therapy and leukemia has been critically evaluated. Two central questions have been studied: 'does leukemia occur more often in GH-deficient children in GH-therapy than in age-related normal individuals' and 'which influences of GH administration upon normal and leukemic leukocytes have been described?'. In some cases leukemia developed in GH-deficient children after GH-therapy. The data have shown a higher incidence of leukemia in the population of children treated with GH (5:100,000) than in the age-related normal population of children (2:100,000). However, hard evidence supporting the hypothesis that GH-therapy could induce leukemia has not yet been found. In vivo studies could not detect enhanced growth of blood cells influenced by GH-therapy. In vitro studies showed that GH either stimulated or did not affect the proliferation of unstimulated lymphocytes of GH-deficient children, normal individuals or leukemia-patients. The same effects occurred in leukemic cell lines. On PHA-stimulated lymphocytes of GH-deficient children and normal individuals both enhancing and inhibiting effects of GH have been found. It is suggested that GH-therapy could improve immunological resistance against tumors by improving Natural-Killer-cell activity. In mice GH seemed to influence lymphocyte-differentiation. In mice also an increase in the frequency of chromosomal aberrations related to GH has been observed. This evaluation suggests that patients, treated with GH-therapy should be carefully followed up. Also, the indication for GH-therapy has to be guarded critically.