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Growth Hormone Deficiency

Addition of aromatase inhibitor to growth hormone therapy does not improve growth outcomes

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A study found that adjuvant aromatase inhibitor use with growth hormone therapy did not increase final adult height in male childhood cancer survivors.

The retrospective cohort study included male childhood cancer survivors with growth hormone deficiency who were treated between 2007 and 2023. Patients (n=92) were treated with growth hormone therapy with (n=22) or without (n=70) an aromatase inhibitor. Mean age at aromatase inhibitor initiation was 13.7 years. Final adult height was defined as height at the fusion of growth plates or 18 years of age.

Patients receiving adjuvant aromatase inhibitor therapy more commonly underwent stem cell transplant, abdominal radiation, total body irradiation, and cis-retinoic acid (P<.01).

Lower final adult height Z-score was associated with:

  • History of spinal radiation (β=–93)
  • Lower starting height Z-score (β=–8)
  • Greater difference between bone age and chronological age (β=–3)

Adjuvant aromatase inhibitor therapy did not increase final adult height compared with growth hormone monotherapy in this patient cohort.

“Future work is needed to determine the optimal adjunctive treatment to maximize final adult height for this population,” the authors concluded.

Reference

Pollock NI, Song M, Wolf AJ, et al. Exploring height outcomes with adjuvant aromatase inhibition in growth hormone–deficient male survivors of childhood cancer. Pediatr Blood Cancer. 2024:e31117. doi:10.1002/pbc.31117

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