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Recent Status in the Occurrence of Leukemia in Growth Hormone-Treated Patients in Japan

Department of Pediatrics, Hiroshima Red Cross Hospital (Y.N.), Hiroshima 730-8619; National Children’s Hospital (T.T., T.S.), Tokyo 154-0004; Tokyo Women’s Medical University (K.TA.), Tokyo 162-0054; Hokkaido University (K.F.), Sapporo 060-8638; Igarashi Children’s Clinic (Y.I.), Sendai 982-0831; Hanew Clinic (K.H.), Sendai 980-0824; Ibaraki Children’s Hospital (T.H.) Mito 311-4145; Toranomon Hospital (S.Y.), Tokyo 105-0001; Kanagawa Children’s Medical Center (K.T.), Yokohama 232-0066; and Tokyo Agricultural University (S.W.), Tokyo 156-8502, Japan

Address all correspondence and requests for reprints to: Yoshikazu Nishi, M.D., Department of Pediatrics, Hiroshima Red Cross Hospital, 1–9-6 Senda-machi, Naka-ku, Hiroshima 730-8619, Japan.

The Foundation for Growth Science in Japan has monitored the safety and efficacy of GH treatment in GH-deficient patients since 1975. Data were collected from more than 32,000 patients up to December 31, 1997. New leukemia was observed in 14 patients and myelodysplastic syndrome (MDS) in one patient. The types of leukemia were acute lymphocytic leukemia (n = 6; 40%), acute myelocytic leukemia or MDS (n = 7; 47%), and chronic myelocytic leukemia (n = 2; 13%). Leukemia developed in 9 patients during GH treatment and in 6 after the cessation of GH treatment. Six patients had known risk factors for leukemia, such as Fanconi’s anemia and previous radiation or chemotherapy. Patient-years of GH therapy was defined as the time from the first dose of GH to the date of the last visit during GH therapy, and patient-years of risk was defined as the time from the first dose of GH to December 31, 1997. The incidence of leukemia of patient-years of GH therapy and patient-years of risk in GH-treated patients without risk factors was 3.0/100,000 and 3.9/100,000, respectively, a figure similar to the incidence in the general population aged 0–15 yr.

We conclude that the incidence of leukemia in GH-treated patients without risk factors is not greater than that in the general population aged 0–15 yr, and a possible increased occurrence of leukemia with GH treatment appears to be limited to patients with risk factors.

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