J Korean Med Sci.  2009 Dec;24(6):1071-1077. 10.3346/jkms.2009.24.6.1071.

Endocrine Complications after Hematopoietic Stem Cell Transplantation during Childhood and Adolescence

• Jung MH
• Cho KS
• Lee JW
• Chung NG
• Cho B
• Suh BK
• Kim HK
• Lee BC

• KMID: 1783135
• DOI: http://doi.org/10.3346/jkms.2009.24.6.1071

Abstract

Long-term survivors of hematopoietic stem cell transplantation (HSCT) during childhood and adolescence are at risk of developing endocrine complications. The purpose of this study was to evaluate the long-term endocrine complications and their associated risk factors among such patients. We reviewed the data from 111 patients (59 males and 52 females) who underwent HSCT at the mean age of 8.3+/-4.1 yr. Thirty patients (27.0%) had growth impairment, and seven (21.2%) out of 33 patients who attained final height reached final height below 2 standard deviation (SD). The final height SD score of the patients conditioned with total body irradiation (TBI) was significantly lower than that of the patients conditioned without TBI (-1.18+/-1.14 vs. -0.19+/-0.78, P=0.011). Thirteen patients (11.7%) developed hypothyroidism (11 subclinical, 2 central) 3.8+/-1.8 (range 1.6-6.2) yr after HSCT. Nineteen (65.5%) out of 29 females had evidence of gonadal dysfunction, and 18 (64.3%) out of 28 males had evidence of gonadal dysfunction. The risk for gonadal dysfunction was significantly higher in females conditioned with busulfan/cyclophosphamide (P=0.003). These results suggest that the majority of patients treated with HSCT during childhood and adolescence have one or more endocrine complications. Therefore, multiple endocrine functions should be monitored periodically after HSCT until they reach adult age.

Keyword

Endocrine Complications; Transplantation; Childhood

MeSH Terms

Adolescent
Adult
Body Height
Child
Child, Preschool
Endocrine System Diseases/*etiology/physiopathology
Female
Gonadal Disorders/etiology
Growth Disorders/etiology
Hematopoietic Stem Cell Transplantation/*adverse effects
Humans
Infant
Male
Thyroid Diseases/etiology
Transplantation Conditioning/adverse effects
Whole-Body Irradiation/adverse effects

Figure

• 

  Fig. 1 The final height (Ht) standard deviation score (SDS) of the patients showed a decreasing tendency compared to the height SDS at diagnosis or at hematopoietic stem cell transplantation (HSCT).

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