Document Detail


Cardiovascular risk, cardiac function, physical activity, and quality of life with and without long-term growth hormone therapy in adult survivors of childhood acute lymphoblastic leukemia.
MedLine Citation:
PMID:  20484480     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Cecilia Follin; Ulf Thilén; Kai Osterberg; Jonas Björk; Eva Marie Erfurth
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-05-19
Journal Detail:
Title:  The Journal of clinical endocrinology and metabolism     Volume:  95     ISSN:  1945-7197     ISO Abbreviation:  J. Clin. Endocrinol. Metab.     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-08-05     Completed Date:  2010-08-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0375362     Medline TA:  J Clin Endocrinol Metab     Country:  United States    
Other Details:
Languages:  eng     Pagination:  3726-35     Citation Subset:  AIM; IM    
Affiliation:
Department of Endocrinology, Lund and Malmö University Hospital, Lund University, SE-221 85 Lund, Sweden.
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MeSH Terms
Descriptor/Qualifier:
Adult
Body Composition
Body Mass Index
Cardiovascular Diseases / etiology
Child
Female
Heart Function Tests
Human Growth Hormone / deficiency,  therapeutic use*
Humans
Male
Motor Activity
Patient Selection
Precursor Cell Lymphoblastic Leukemia-Lymphoma / drug therapy*,  psychology
Prospective Studies
Quality of Life / psychology*
Questionnaires
Risk
Risk Factors
Social Support
Statistics, Nonparametric
Survivors
Chemical
Reg. No./Substance:
12629-01-5/Human Growth Hormone

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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