Late Endocrine Complications in Childhood Cancer Survivors

Lee, Ji Hye; Seo, Hyun Ji; Kim, Ji Yoon; Ko, Cheol Woo; Lee, Kun Soo

Abstract

PURPOSE
This study is aimed to find out the incidence of late endocrine complications in children who were treated for childhood cancer. METHODS: We reviewed the medical records of 60 patients who was treated for childhood cancer and evaluated various pituitary hormonal functions after completion of treatment from July 1985 to September 2004 at Kyungpook National University Hospital. RESULTS: Forty-four boys (73.3%) and sixteen girls (26.7%) were involved in the study and their ages ranged from 2 months to 14 years. Twenty-four patients were treated with chemotherapy with cranial irradiation and thirty-six were treated with chemotherapy only. The diagnoses included ALL (n=27, 45.0%), AML (n=2, 3.3%), malignant lymphoma (n=13, 21.7%), brain tumor (n=5, 8.3%), MDS (n=1, 1.7%), and other solid tumor (n=12, 20.2%). Forty-four (73.3%) out of the 60 patients had an additional endocrine abnormality. Growth hormone deficiency (GHD) was identified in 44 children (73.3%). Incidence of GHD was significantly higher among those who had received cranial irradiation (91.6% vs. 61.1%) (P=0.009) but this kind of difference was not found in ALL 27 patients (93.7% vs. 72.7%) (P=0.131). Only one patient was diagnosed as primary hypothyroidism, two patients were diagnosed as primary hypogonadism, and these three patients showed growth hormone deficiency. No patient had abnormalities of ACTH and cortisol. CONCLUSION: We thought that late endocrine complications were very common in childhood cancer survivors. Accordingly, we recommended that we should focus on endocrine abnormalities while treating and following up the patients.