GROWTH HORMONE (GH) DEFICIENCY ASSOCIATED WITH CRANIAL RADIATION IN ACUTE LYMPHOCYTIC LEUKEMIA (ALL)

Abstract

Thirteen longterm survivors of ALL, 8 males and 5 females, 9-17 yrs of age, treated with chemotherapy and cranio-spinal radiation (1800-2500 rads) were evaluated for GH deficiency. Patients (pts) were separated based on their stimulated GH levels (SGH) into group 1, SGH > 10 ng/ml and group 2, SGH < 10 ng/ml. All pts in group 1 and 8 pts in group 2 were pubertal. Anthropometric and laboratory data are indicated in Table. GHC=GH concentration; SDS=standard deviation score, ht.=height The 24-hr GHC correlated significantly with sleep GH peak, SGH and gonadal steroid level but not with Sm C, growth velocity, total rads or age at time of radiation. CONCLUSIONS: 1. Complete or partial GH deficiency occurred in 60% of pts treated with cranial radiation, 2. Puberty associated growth spurt masked the decline in growth velocity due to GH deficiency, and 3. The severity of growth retardation did not correlate with GH reserve suggesting that spinal radiation had a significant deleterious effect on stature.