GROWTH AFTER RECOMBINANT HUMAN GROWTH-HORMONE (RHGH) TREATMENT IN TRANSPLANTED THALASSEMIC PATIENTS

The aim of this study was to evaluate the treatment effects with recom binant human growth hormone (rhGH) in a group of patients after bone m arrow transplantation for thalassemia major. At the end of treatment w e divided the subjects into two groups according to the outcome of the therapy: responder and non-responder. Responder group: after 24 month s of rhGH administration, growth rate was still significantly higher i n respect to start of treatment (P < 0.0001). Plasma levels of IGF-I r ose significantly (P < 0.003). The serum levels of serum asparate amin otransferase (SGOT) and alanine aminotransferase (SGPT) were higher co mpared to normal values but improved in non-responder patients. There was no difference in the mean concentration of these parameters before and after treatment (P = NS). Non-responder group: these patients had a worsening of the growth rate during rhGH administration. There was no increase of the IGF-I levels. Single values of transaminase and fer ritin levels were higher than in responder patients before and after t reatment. There was a significant correlation between IGF-I, SGOT, SGP T and ferritin in all patients before and after therapy. It appears fr om these data that rhGH administration is worth serious consideration in patients after BMT for thalassemia major presenting impaired growth hormone secretion. This treatment can offer good results only in case s where the normal hepatic synthesis of IGF-I is conserved and where l iver damage has not reached irreversible conditions, as we have seen i n the responder group.