Acute lymphoblastic leukemia following treatment with human growth hormone in a boy with possible preanemic Fanconi's anemia.

The patient had a low birth weight and was born with appearance anomalies including microcephalus, microphthalmia, hypoplastic mandible, double chin due to cutaneous fold, micropenis. Ability to move and intelligence appeared to develop normally, but growth was markedly retarded. In June 1982, at the age of 2 yr 4 mo, the patient underwent tolerance tests whereby a deficiency of human growth hormone (GH) was proved by poor GH secretion response. GH was administered until April 1985 when acute lymphoblastic leukemia developed. The patient's younger brother, born in 1986, had similar birth anomalies and was diagnosed as having Fanconi's anemia. It therefore seems possible that our patient developed his acute leukemia through the stimulatory effect which GH had on a predisposition to leukemia.