Survivors of childhood (CO) ALL treated with prophylactic cranial radiotherapy (CRT) often exhibit (GHD) and increased cardiovascular risk. The aim of this study was to evaluate the effect of 4 years of GH therapy on cardiovascular risk factors in 16 former ALL patients and to compare them with matched population controls after 4 years.
Sixteen former CO ALL patients (women=8), aged 2437 years, treated with CRT (1824 Gy) and chemotherapy with confirmed GHD and controls were studied at baseline. After 4 years of GH therapy (median 0.5 mg/day) the investigations were repeated in the patients and in the control subjects.
Four years of GH treatment increased the serum IGF-1 significantly into the mid-normal range (SDS IGF-1 0.3) in the former ALL patients (P=0.03). Compared to baseline, a significant decrease in the plasma levels of glucose (P=0.03), apoprotein B (apo B) (P=0.03) and the ratio apo B/apoprotein A1 (apo A1) (P=0.006). Also HDL cholesterol (P=0.03) and apo A1 (P=0.05) increased significantly compared to baseline levels. Comparison between patients and controls after 4 years showed no significant difference. There was no difference in fatmass at baseline between patients and controls and four years of GH treatment did not change fatmass in the patients. The blood pressure showed no significant difference in patients after four years of GH.
In conclusion, 4 years of GH therapy to former CO ALL patients resulted in significant improvements in the plasma levels of glucose, apo B, apo A1, apoB/apoA1 and HDL, indicating a positive effect of GH on cardiovascular risk.
03 - 07 May 2008
European Society of Endocrinology