ESPE Abstracts (2015) 84 P-3-954

Long-Term Effects of GH Replacement Therapy on Hematopoiesis in GH Deficient Children

Andrea Esposito, Lucia De Martino, Flavia Barbieri, Martina Rezzuto, Nicola Improda, Manuela Cerbone, Donatella Capalbo & Mariacarolina Salerno


Pediatric Endocrinology Unit, Department of Translational Medical Sciences, University of Naples Federico II, Naples, Italy


Background: Among their metabolic effects, GH and its mediator IGF1 have been reported to influence hematopoiesis. Indeed, GH/IGF1 axis promotes erythropoiesis and GH deficiency (GHD) has been associated with a normochromic and normocytic anemia both in adults and in children. In contrast, in vivo data on the effects of GH/IGF1 axis on leukocytes and platelets are scanty.

Objective and hypotheses: To evaluate the effects of 4-years GH replacement therapy (GHRT) on hematopoiesis in GHD children.

Method: 100 GHD children (64 males) aged 9.74±3.95 years were enrolled in the study. Anthropometric measures, serum IGF1 levels and blood count were evaluated at baseline and then annually during the first 4 years of GHRT. 100 healthy children sex- and age- comparable to the patients were enrolled as controls and evaluated annually.

Results: At the start of the study GHD children showed levels of hemoglobin (Hb) (12.5±1.1 g/dl) and hematocrit (Hct) (36.7±4.0%) lower than controls (Hb 13.0±1.0 g/dl, P<0.002; Hct38.1±4.3%, P<0.02). 4 years of GHRT were associated with a significant increase in Hb (13.2±1.0 g/dl, P<0.0001) and Hct (39.0±3.4%, P<0.0001) which became comparable to controls (Hb13.3±1.3 g/dl; Hct39.7±7.8%). Hb levels significantly correlated with IGF1 serum levels (r=0.32, P<0.0001). At baseline seventeen GHD children (17%) showed a normochromic, normocytic anemia while after 4 years of GHRT only two patients (2%) were still anaemic. No difference in leukocytes and platelets count was detected between patients and controls neither at baseline nor during the study.

Conclusion: GHD in children is associated with a significant reduction in Hband Hct.Long-term GHRT improves these anomalies. Neither GHD nor GHRT have effects on leukocytes and platelets parameters.

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