TY - JOUR
T1 - Recombinant growth hormone use pretransplant and risk for post-transplant lymphoproliferative disease - A report of the NAPRTCS
AU - Dharnidharka, Vikas R.
AU - Talley, Lynya I.
AU - Martz, Karen L.
AU - Stablein, Donald M.
AU - Fine, Richard N.
PY - 2008/9
Y1 - 2008/9
N2 - rhGH, widely used to optimize linear growth in children with ESRD, also modulates B-cell precursor development and may be associated with malignancy development. To determine if rhGH use in children was associated with higher risk of PTLD, we analyzed retrospectively collected data on children with CRI, on dialysis or with renal transplants in a large multi-center registry of children with ESRD. Of the 194 LPD patients currently listed in the registry, 41 were previously enrolled in the CRI registry and 18/41 (43.9%) used rhGH during their period with CRI. Among CRI patients who later received a transplant, rates of PTLD post-transplant were significantly higher among rhGH users (18/407 or 4.4%) compared to patients who never used rhGH during their CRI follow-up and received a transplant (23/1240 or 1.9%, p = 0.009). After adjusting for the confounders of recipient age (at CRI and at transplant) and transplant era, the use of rhGH pretransplant was associated with a borderline higher risk for PTLD (odds ratio 1.88, 95% CI = 1.00-3.55, p = 0.05). In contrast, use of rhGH during dialysis or post-transplant only was not associated with a higher risk for PTLD. Continued monitoring is recommended.
AB - rhGH, widely used to optimize linear growth in children with ESRD, also modulates B-cell precursor development and may be associated with malignancy development. To determine if rhGH use in children was associated with higher risk of PTLD, we analyzed retrospectively collected data on children with CRI, on dialysis or with renal transplants in a large multi-center registry of children with ESRD. Of the 194 LPD patients currently listed in the registry, 41 were previously enrolled in the CRI registry and 18/41 (43.9%) used rhGH during their period with CRI. Among CRI patients who later received a transplant, rates of PTLD post-transplant were significantly higher among rhGH users (18/407 or 4.4%) compared to patients who never used rhGH during their CRI follow-up and received a transplant (23/1240 or 1.9%, p = 0.009). After adjusting for the confounders of recipient age (at CRI and at transplant) and transplant era, the use of rhGH pretransplant was associated with a borderline higher risk for PTLD (odds ratio 1.88, 95% CI = 1.00-3.55, p = 0.05). In contrast, use of rhGH during dialysis or post-transplant only was not associated with a higher risk for PTLD. Continued monitoring is recommended.
KW - Growth hormone
KW - Kidney transplant
KW - Post-transplant lymphoproliferative disease
UR - http://www.scopus.com/inward/record.url?scp=49349102935&partnerID=8YFLogxK
U2 - 10.1111/j.1399-3046.2007.00881.x
DO - 10.1111/j.1399-3046.2007.00881.x
M3 - Article
C2 - 18179637
AN - SCOPUS:49349102935
SN - 1397-3142
VL - 12
SP - 689
EP - 695
JO - Pediatric transplantation
JF - Pediatric transplantation
IS - 6
ER -