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Mortality increases with prior malignancy in children treated with GH
In children treated with growth hormone, those with a prior malignancy or an underlying serious medical condition unassociated with growth hormone deficiency had higher mortality rates than those with idiopathic growth hormone deficiency or other growth disorders, published findings indicate.
Charmian A. Quigley, MBBS, FRACP, associate professor of endocrinology at Indiana University School of Medicine in Indianapolis, and colleagues evaluated data from the Genetics and Neuroendocrinology of Short-stature International Study (GeNeSIS) on 9,504 children treated with GH followed for 4 or more years to determine mortality among the children.
The most common diagnostic categories were idiopathic GH deficiency (n = 4,324) and organic GH deficiency (n = 1,612).
Overall, 42 deaths occurred during 67,163 person-years of follow-up (standardized mortality rate [SMR] for all diagnoses combined = 0.77; 95% CI, 0.56-1.05). Participants with organic GH deficiency had elevated SMRs compared with participants with other GH deficiencies (SMR = 6.97; 95% CI, 3.81-11.69). Participants with malignant neoplasia had an increased SMR compared with no significant elevation in participants with benign neoplasia. Participants with idiopathic short stature, short stature associated with small-for-gestational age at birth, Turner’s syndrome or short stature homeobox-containing deficiency did not have significantly elevated SMRs.
“This analysis of over 67,000 patient-years of data, for over 21,000 GH-treated children followed in an observational study found no increase in risk of mortality compared with children in the general population for the majority of diagnostic groups,” the researchers wrote. “However, we found a not unexpected increase in mortality risk for children with history of malignant neoplasia.” – by Amber Cox
Disclosure: Quigley reports being a former employee of Eli Lilly and Company. Please see the full study for a list of all other authors’ relevant financial disclosures.