Treatment with Human Growth Hormone Does Not Increase the Risk of Leukemia
Treatment with Human Growth Hormone Does Not Increase the Risk of Leukemia
Source: Allen DB, et al. J Pediatr 1997;131:S32-36.
A number of reports have suggested that treatment with human growth hormone (HGH) might be associated with an increased risk of childhood leukemia.1 However, it has not been clear whether this purported increased risk was confined to children who had known risk factors or whether HGH treatment increased the risk. Previous studies have been inconclusive because of the relatively small numbers of patients studied. Allen and colleagues, who are associated with the National Comparative Growth Study (NCGS) as well as Genentech, Inc. (the manufacturer of HGH) addressed this point by analyzing the large database on HGH therapy contained in the NCGS. All patients in the United States are entered into the NCGS upon initiation of HGH therapy, and more than 24,000 patients are currently being followed. Data were analyzed between 1985 and 1995. Eleven new cases of leukemia occurred in 24,417 HGH-treated children. In eight of these cases, there was a known risk factor for leukemia (CNS tumor, craniopharyngioma, l; Fanconi or Down syndromes, 2; aplastic anemia, 1). Three case of leukemia occurred in 21,705 children treated with HGH for idiopathic growth hormone deficiency, idiopathic short stature, or other dysmorphic syndromes. The risk of developing leukemia was estimated on the basis of the patient years of HGH use and also by the patient years elapsed since HGH therapy was initiated. These risks were compared with expected risk rates developed by the Surveillance, Epidemiology, and End Results program of the National Cancer Institute.
The three cases of leukemia occurring in patients without known risk factors in the time since onset of HGH therapy are comparable with the expected risk in a general population of 3.42 cases during a comparable time span. The two cases that occurred during HGH therapy are also comparable with 2.13 expected cases.
If children with known, antecedent risk factors are excluded, there appears to be no increased risk for the development of leukemia, either during or following HGH therapy.
Reference
1. Watanbe S, et al. Leukemia and other malignancies among GH users. J Pediatr Endocrinol 1993;6:99-108.
True statements about human growth hormone treatment include all of the following except:
a. HGH has been implicated in the past as causing an increased risk of leukemia.
b. HGH does not increase risk of leukemia if other risk factors are taken into account.
c. the risk of leukemia may be increased in the years following HGH therapy.
d. an apparent increased risk of leukemia may have been a result of small sample size.
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