Growth Hormone Deficiency and Treatment in Childhood Cancer Survivors

Front Endocrinol (Lausanne). 2021 Oct 22:12:745932. doi: 10.3389/fendo.2021.745932. eCollection 2021.

Abstract

Growth hormone (GH) deficiency is a common pituitary hormone deficiency in childhood cancer survivors (CCS). The identification, diagnosis, and treatment of those individuals at risk are important in order to minimize associated morbidities that can be ameliorated by treatment with recombinant human GH therapy. However, GH and insulin-like growth factor-I have been implicated in tumorigenesis, so there has been concern over the use of GH therapy in patients with a history of malignancy. Reassuringly, GH therapy has not been shown to increase risk of tumor recurrence. These patients have an increased risk for development of meningiomas, but this may be related to their history of cranial irradiation rather than to GH therapy. In this review, we detail the CCS who are at risk for GHD and the existing evidence on the safety profile of GH therapy in this patient population.

Keywords: brain tumors; childhood cancer survivors (CCS); growth hormone deficiency; growth hormone treatment; secondary neoplasm; tumor recurrence.

Publication types

  • Review

MeSH terms

  • Adult
  • Brain Neoplasms* / epidemiology
  • Brain Neoplasms* / therapy
  • Cancer Survivors* / statistics & numerical data
  • Child
  • Cranial Irradiation / adverse effects
  • Growth Disorders / drug therapy
  • Growth Disorders / epidemiology
  • Growth Disorders / etiology
  • Growth Disorders / metabolism
  • Hormone Replacement Therapy
  • Human Growth Hormone / deficiency*
  • Human Growth Hormone / therapeutic use
  • Humans
  • Hypopituitarism / drug therapy
  • Hypopituitarism / epidemiology
  • Hypopituitarism / etiology
  • Hypopituitarism / metabolism
  • Insulin-Like Growth Factor I / metabolism
  • Risk Factors

Substances

  • IGF1 protein, human
  • Human Growth Hormone
  • Insulin-Like Growth Factor I