Korean J Pediatr.  2013 Jul;56(7):298-303. 10.3345/kjp.2013.56.7.298.

Risk factors for short term thyroid dysfunction after hematopoietic stem cell transplantation in children

• Jung YJ
• Jeon YJ
• Cho WK
• Lee JW
• Chung NG
• Jung MH
• Cho B
• Suh BK

• KMID: 2284257
• DOI: http://doi.org/10.3345/kjp.2013.56.7.298

Abstract

PURPOSE
The purpose of this study was to evaluate short-term thyroid dysfunction and related risk factors in pediatric patients who underwent hematopoietic stem cell transplantation (HSCT) during childhood.
METHODS
We studied 166 patients (100 boys and 66 girls) who underwent HSCT at the Catholic HSCT Center from January 2004 through December 2009. The mean age at HSCT was 10.0+/-4.8 years. Thyroid function of the patients was tested before and during 3 months of HSCT.
RESULTS
Out of 166 patients, 165 (99.4%) underwent allotransplantation. Acute graft-versus-host disease (GVHD, grades II to IV) developed in 76 patients. Conditioning regimens before HSCT include total body irradiation (n=57), busulfan (n=80), and reduced intensity (n=29). Forty-five (27.1%) had thyroid dysfunction during 3 months after HSCT (29 euthyroid sick syndrome [ESS], 6 subclinical hyperthyroidism, 4 subclinical hypothyroidism, 3 hypothyroxinemia, 2 overt hyperthyroidism, and 1 high T4 syndrome). In a univariate logistic regression analysis, age at HSCT (P=0.002) and acute GVHD (P=0.009) had statistically significant relationships with thyroid dysfunction during 3 months after HSCT. Also, in a univariate logistic regression analysis, ESS (P=0.014) showed a strong statistically significant association with mortality.
CONCLUSION
In our study 27.1% patients experienced thyroid dysfunction during 3 months after HSCT. Increase in age and acute GVHD may be risk factors for thyroid dysfunction during 3 months after HSCT. There was a significant association between ESS and mortality.

Keyword

Hematopoietic stem cell transplantation; Thyroid dysfunction; Child; Graft-vs-host disease; Euthyroid sick syndrome

MeSH Terms

Busulfan
Child
Euthyroid Sick Syndromes
Graft vs Host Disease
Hematopoietic Stem Cell Transplantation
Hematopoietic Stem Cells
Humans
Hyperthyroidism
Hypothyroidism
Logistic Models
Risk Factors
Thyroid Gland
Whole-Body Irradiation
Busulfan