GROWTH-HORMONE REPLACEMENT IN PATIENTS WITH LANGERHANS CELL HISTIOCYTOSIS

Objectives-To assess the impact of growth hormone on growth and the un derlying disease in children with growth hormone deficiency as a resul t of Langerhan's cell. histiocytosis. Study design-Retrospective analy sis of data from the Kabi (Pharmacia & Upjohn) international growth da tabase (KIGS) for 82 children with Langerhan's cell histiocytosis trea ted with recombinant growth hormone. Results-At the start of treatment the median (10-90th centile) age was 9.0 (5.2 to 14.7) years, with a median height standard deviation score (SDS) of -2.0 (-3.5 to -0.9). T he median pretreatment height velocity (measured in cm/year) was 3.6 ( 0.9 to 6.4); this increased to 8.8 (3.8 to 12.0) in the first year of treatment with growth hormone, and then remained significantly greater than the pretreatment height velocity at 7.3 (4.4 to 9.7) and 7.1 (4. 1 to 9.3) cmlyear in the second and third years, respectively. The med ian height SDS increased from -2.0 to -0.8 (-2.3 to 0.6) by the end of three years of treatment. There was no increase in the recurrence rat e of the underlying disease and no adverse event could be directly att ributed to growth hormone treatment, apart from one case of benign int racranial hypertension that resolved on stopping treatment with growth hormone. Conclusions-Growth hormone replacement treatment for patient s with Langerhan's cell histiocytosis with growth hormone deficiency i s beneficial and safe.