Recombinant growth hormone use pretransplant and risk for post-transplant lymphoproliferative disease--a report of the NAPRTCS

Pediatric Transplantation
Vikas R DharnidharkaRichard N Fine

Abstract

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.

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Citations

Oct 22, 2009·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Ryszard Grenda
Nov 21, 2009·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Rajiv SinhaStephen D Marks
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Aug 18, 2020·Experimental and Clinical Transplantation : Official Journal of the Middle East Society for Organ Transplantation·Yuta HirataNaohiro Sata
Dec 29, 2020·Frontiers in Pediatrics·Mercedes Lopez-GonzalezGema Ariceta

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