Growth Hormone Therapy in Paediatric Oncology Survivors: Case Series from a Malaysian Tertiary Centre
https://doi.org/10.15605/jafes.041.S1
- Author:
Nur Amalina Yusof
1
;
Lim Poi Giok
1
;
Arliena Amin
1
Author Information
1. Paediatric Endocrinology Unit, Department of Paediatrics, Hospital Tunku Azizah
- Publication Type:Journal Article
- MeSH:
Child;
Neoplasms;
Growth Hormone;
Survivors
- From:
Journal of the ASEAN Federation of Endocrine Societies
2026;41(S1):145-
- CountryPhilippines
- Language:English
-
Abstract:
Introduction:Growth hormone deficiency (GHD) is a recognized
endocrine complication among childhood cancer survivors
resulting from disruption of hypothalamic–pituitary axis
due to tumors, neurosurgery, or cranial irradiation. While
recombinant human growth hormone (rhGH) therapy
improves growth and metabolic outcome, concerns remain
regarding its long-term safety with risk of tumor recurrence
and secondary neoplasm. We present a case series of
five paediatric oncology survivors with confirmed GHD
receiving rhGH in Hospital Tunku Azizah, highlighting
our clinical experience in comparison with international
practice.
Case:Five paediatric oncology survivors (acute lymphoblastic
leukemia, craniopharyngioma, medulloblastoma, and
supratentorial PNET) with GHD were commenced on
rhGH therapy 2.5–5.5 years after completion of cancer
treatment. All patients had significant short stature with a
mean height SDS of −3.22 prior to the initiation of therapy.
GHD was confirmed biochemically with low IGF-1 level
and dynamic testing (peak GH 0.35–4.61 ng/mL). Among
the four patients with brain tumors, two had stable residual disease while the remaining were tumor-free. rhGH therapy
was temporarily ceased in two patients due to minor
increment in tumor size but was successfully resumed
following stabilization without further complications
to date. Two patients are concurrently on pubertal
induction. Most patients demonstrated catch-up growth
with increased height velocity, supporting the efficacy of
rhGH in this population. No secondary malignancies or
significant adverse events were observed during follow-up.
Conclusion:Paediatric oncology survivors with GHD in this series
demonstrated a favorable response to rhGH therapy,
evidenced by improvements in height SDS and growth
velocity, while maintaining oncological stability in
the majority of cases. Our findings are consistent with
international data, supporting cautious but appropriate
use of rhGH in this population. Careful patient selection
and close multidisciplinary monitoring remain essential.
- Full text:2026081017194509581EP_P021.pdf
