- Imatinib mesylate
- Growth hormone deficiency
- Chronic myeloid leukemia
Objective: The purpose of this study was to determinewhether or not imatinib mesylate therapy induces growth hormone deficiency (GHD). Subjects and Methods: Seventeen patients with chronic myloid leukemia (CML) were enrolled in the study. The glucagon stimulation test (GST), and standard deviation scores (SDSs) of insulin-like growth fac- tor 1 (IGF-I) and insulin-like growth factor binding protein (IGFBP-3) were used to determine GHD. The L-dopa test was performed on those with IGF-I SDSs above the –1.8 cut-off level. Results: Of the 17 patients in the study, 12 (70%) had severe GHD (serum GH level <3 μg/l after GST). IGF-I SDSs and IGFBP-3 SDSs were below –1.8 in 12 patients (70%) and below –0.9 in 10 subjects (58%). Four of the 5 remaining subjects with IGF-I SDS >–1.8 showed insufficient GH response to L-dopa stimulation. Nine subjects (52%) had both severe GHD based on GST response and IGF-I SDS below –1.8. If an IGF-I SDS cut-off value l<–3 were used,5 out of 17 subjects (30%) would be classified as GH deficient. These same patients also showed severe GHD based on GST response. Conclusions: The data showed that a large number of patients on imatinib mesylate therapy had GH deficiency. A study involving a larger number of patients with a matched control group is needed to confirm the present observations.
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- Deininger MW, Druker BJ: Specific targeted therapy of chronic myelogenous leukemia with imatinib mesylate. Pharmacol Rev 2003;55:401–423.
- Mayo KE, Miller T, DeAlmeida V, Godfrey P, Zheng J, Cunha SR: Regulation of the pituitary somatotroph cell by GHRH and its receptor. Recent Prog Horm Res 2000;55:266–267.
- Anderson LL, Jeftinija S, Scanes CG: Growth hormone secretion: molecular and cellular mechanisms and in vivo approaches. Exp Biol Med (Maywood) 2004;229:291–302.
- Biller BM, Samuels MH, Zagar A, Cook DM, Arafah BM, Bonert V, Stavrou S, Kleinberg DL, Chipman JJ, Hartman ML: Sensitivity and specificity of six tests for the diagnosis of adult GH deficiency. J Clin Endocrinol Metab 2002;87:2067–2079.
- Boquete HR, Sobrado PG, Fideleff HL, Sequera AM, Giaccio AV, Suárez MG, Ruibal GF, Miras M: Evaluation of diagnostic accuracy of insulin-like growth factor (IGF)-I and IGF-binding protein-3 in growth hormone-deficient children and adults using ROC plot analysis. J Clin Endocrinol Metab 2003;10:4702–4708.
- Corneli G, Gasco V, Prodam F, Grottoli S, Aimaretti G, Ghigo E: Growth hormone levels in the diagnosis of growth hormone deficiency in adulthood. Pituitary 2007;10:141–149.
- Kwan AY, Hartman ML: IGF-I measurements in the diagnosis of adult growth hormone deficiency. Pituitary 2007;10:151–157.
- Pastural E, Takahashi N, Dong WF, Bainbridge M, Hull A, Pearson D, Huang S, Lowsky R, DeCoteau JF, Geyer CR. RIZ1 repression is associated with insulin-like growth factor-1 signaling activation in chronic myeloid leukemia cell lines. Oncogene 2007;26:1586–1594.
- Molitch ME, Clemmons DR, Malozowski S, Merriam GR, Shalet SM, Vance ML, Stephens PA: Evaluation and treatment of adult growth hormone deficiency: an Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab 2006;91:1621–1634.
- Oliveira MR, Ohnuma L, Bendit I, Dorlhiac-Lacer P, Giannella-Neto D: Interferon-α therapy increases type I insulin-like growth factor receptors expression on lymphoid cells from patients with chronic myelogenous leukemia. Leuk Res 2001;25:711–717.
- Celniker AC, Chen AB, Wert RM Jr, Sherman BM: Variability in the quantitation of circulating growth hormone using commercial immunoassays. J Clin Endocrinol Metab 1989;68:469–476.
- Granada ML, Ulied A, Casanueva FF, Pico A, Lucas T, Torres E, Sanmartí A: Serum IGF-I measured by four different immunoassays in patients with adult GH deficiency or acromegaly and in a control population. Clin Endocrinol (Oxf) 2008;68:942–950.
- Kerkelä R, Grazette L, Yacobi R, Iliescu C, Patten R, Beahm C, Walters B, Shevtsov S, Pesant S, Clubb FJ, Rosenzweig A, Salomon RN, Van Etten RA, Alroy J, Durand JB, Force T: Cardiotoxicity of the cancer therapeutic agent imatinib mesylate. Nat Med 2006;12:908–916.
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Received: October 12, 2008
Revised: November 23, 2008
Published online: July 31, 2009
Number of Print Pages : 4
Number of Figures : 0, Number of Tables : 1, Number of References : 13
Medical Principles and Practice (International Journal of the Kuwait University Health Sciences Centre)
Vol. 18, No. 5, Year 2009 (Cover Date: August 2009)
Journal Editor: Owunwanne A. (Kuwait)
ISSN: 1011-7571 (Print), eISSN: 1423-0151 (Online)
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