Abstract
26 patients grafted for various reasons ( SAA N=3; ALL N=16; CML N=4; neurobl N=2; AML N=1) were followed-up. Hypothalamo/pituitary function was tested with LHRH, TRH, GHRH and arginine. Basal serum levels of T, E2, T4, IGF-I, IGF-II, IGF-BP (GH-dependent, 150 kD) were measured (RIA). In cases with poor growth short-term responses of IGFs and IGF-BP to r-hGH (0.07 U/kg BW, 4d s.c.) were investigated. - In 14 cases growth impairment was present (10 prepub). In only 2 of these cases GHD could be proven. In 9 cases IGF-I was also low with normal IGF-II and (in contrast to GHD) IGF-BP, of which 5 showed liver GVH. In 3 cases no abnormalities of hGH and IGFs were seen. IGFs and IGF-BP were less responsive to r-hGH than in GHD.
Conclusions: 1. In general, growth failure and hormonal abnormalities in patients after BMT are primarily related to the extent of prior irradiation and may, thus, be prevented by other X-ray schedules. 2. Mostly, growth failure after BMT corresponds with primarily diminished IGF-I production (from the liver (GVH) or at the sites of growing tissues). Thus, means to elevate IGFs might be tried to treat cases with severe growth failure.
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Ranke, M., Blum, W., Dopfer, R. et al. 59 GROWTH-RELATED HORMONAL CHANGES AFTER ALLOGENEIC BONE MARROW TRANSPLANTATION (BMT) IN CHILDREN AND ADOLESCENTS. Pediatr Res 24, 527 (1988). https://doi.org/10.1203/00006450-198810000-00080
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DOI: https://doi.org/10.1203/00006450-198810000-00080