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Growth Hormone Treatment Helps Small Babies And Childhood Brain Tumor Survivors Reach Normal Adult Height



CHEVY CHASE, Md., Aug. 11 /PRNewswire/ -- Growth hormone treatment may help children who suffer from specific health conditions, such as brain tumors, reach a normal height as an adult, according to two studies published this month in The Journal of Clinical Endocrinology and Metabolism (JCE&M).


In the first study, researchers in the Netherlands found that short children who are born small for gestational age (SGA) and receive continuous growth hormone (GH) treatment may reach a normal adult height.  The findings are the first to show that a lower dose of GH treatment for short children may be as effective as a higher dose for attaining a normal adult height.


Approximately 15 percent of children who are born SGA do not catch up to normal height in the first two years of life.  Furthermore, sixty percent of short children born SGA have low physiological GH levels.  While previous studies have shown that five years of GH treatment can normalize height in children who are born SGA, this new research is the first to show the results of long-term continuous GH treatment in SGA children.


Dr. Yvonne van Pareren and her colleagues evaluated two doses of long- term, continuous GH treatment in 54 short children who were born SGA.  The children were treated with two doses of GH-either three IU/m(2)/d or six IU/m(2)/d-for approximately eight years.  The findings indicate that long-term GH treatment in most short children who are born SGA can normalize the adult height.


"In our study, long-term GH treatment resulted in an adult height in the normal range in 85 percent of the children and an adult height in the target range for 98 percent of the children," said Professor Anita Hokken-Koelega, the senior author on the study.


The researchers also discovered that the two dosages did not result in significantly different adult heights and note that the 3 IU/m(2)/day dosage proved to be as effective as the higher GH dose (6 IU/m(2)/day).


"Based on our findings, further studies are now needed to develop advanced prediction models that can indicate the best treatment options for each child," notes Dr. van Pareren.


In a second GH study researchers reviewed the improvements that GH treatment has made to final adult height in childhood brain tumor survivors over the past 25 years.  Brain tumors are the second most common form of cancer in children.  Cranial radiotherapy along with spinal irradiation or chemotherapy can impact adversely on growth and reduce adult height. Furthermore, radiation therapy can induce GH deficiency in children.  In a study of the largest cohort of brain tumor survivors from a single center, researchers in the United Kingdom concluded that a combination of GH and gonadotropin-releasing hormone analogue (GnRHa) helps survivors of childhood brain tumors reach normal height as an adult.  The new findings provide the first conclusive evidence about factors affecting the height outcome of brain tumor survivors who receive GH replacement for radiation-induced GH deficiency.


Professor Stephen Shalet and his colleagues at the Christie Hospital in Manchester, England, performed a 25-year retrospective study of 58 patients who reached full adult height and were treated with GH therapy for radiation- induced GH deficiency occurring as a consequence of brain tumor therapy.


"We aimed to assess whether final height has improved in GH replaced childhood brain tumor survivors," explained Professor Shalet.  "We found that the improved treatment schedules and early onset of GH replacement over the past 25 years as well as the combination of GH and GnRHa for those in early puberty has indeed improved final height among childhood brain tumor survivors."


Professor Shalet and his group discovered that children who were treated with GH and GnRHa achieved improved various growth parameters, which allowed many of the children to reach their target height.  Additionally, the researchers note that the auxological outcomes of the treatments were directly affected by the age of the child at the time of the radiation treatment, with the youngest children having the worst prognosis.  The researchers also found that the age at irradiation correlated with the timing of the first assessment of GH status, older children being investigated more quickly presumably because of their more limited remaining growth potential.


"In addition, we found that children who received radiation treatment later over the 25-year timescale were assessed earlier for GH deficiency and started on GH therapy earlier," notes Professor Shalet.  "This change may explain the improvement in final height in more recent years."


JCE&M is one of four journals published by The Endocrine Society.  The Endocrine Society is the world's oldest, largest, and most active organization devoted to research on hormones, and the clinical practice of endocrinology. Endocrinologists are specially trained doctors who diagnose, treat and conduct basic and clinical research on complex hormonal disorders such as diabetes, thyroid disease, osteoporosis, obesity, hypertension, cholesterol and reproductive disorders.  Today, The Endocrine Society's membership consists of over 10,000 scientists, physicians, educators, nurses and students, in more than 80 countries.  Together, these members represent all basic, applied, and clinical interests in endocrinology. The Endocrine Society is based in Bethesda, Maryland.  To learn more about the Society, and the field of endocrinology, visit the Society's web site at www.endo-society.org.


SOURCE  The Endocrine Society  


CO:  Endocrine Society


ST:  Maryland, Netherlands




Web site:  http://www.endo-society.org




08/11/2003 11:37 EDT

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