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Growth hormone therapy and malignancy

S M Shalet1, B M Brennan, R E Reddingius

  • 1Department of Endocrinology, Christie Hospital, Manchester, UK.

Hormone Research
|January 1, 1997
PubMed
Summary

Human growth hormone (GH) therapy is under scrutiny for cancer risks in children. Current surveillance shows no increased risk, but further monitoring is essential due to study limitations.

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Area of Science:

  • Pediatric Endocrinology
  • Oncology
  • Pharmacovigilance

Background:

  • Concerns exist regarding human growth hormone (GH) replacement therapy potentially increasing cancer recurrence or de novo cancer in children previously treated for brain tumors or leukemia.
  • These concerns are fueled by animal studies, the link between acromegaly and malignancy, and a Japanese study reporting de novo leukemia in children treated with GH.

Purpose of the Study:

  • To evaluate the safety of human growth hormone (GH) replacement therapy in pediatric patients, specifically concerning the risk of malignancy.
  • To address the long-standing concerns of pediatricians regarding potential oncogenic effects of GH therapy.

Main Methods:

  • Review of data from single-center studies and pharmaceutical industry surveillance programs.
  • Analysis of existing evidence, acknowledging the absence of prospective randomized controlled trials for GH replacement in radiation-induced GH deficiency.

Main Results:

  • Current surveillance data from single-center studies and industry programs have not demonstrated evidence of an increased risk of malignancy (recurrent or de novo) associated with GH therapy.
  • However, wide confidence intervals in these studies limit definitive conclusions.

Conclusions:

  • While current evidence is reassuring, the limitations of existing studies, particularly the lack of prospective randomized trials, necessitate continued high-level surveillance for potential cancer risks in children receiving GH therapy.
  • Ongoing vigilance is crucial for ensuring patient safety in pediatric GH treatment.

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