Browse > Article

Short-term follow up of thyroid function after pediatric hematopoietic stem cell transplantation  

Lee, Seon-Ju (Department of Pediatrics, College of Medicine, The Catholic University of Korea)
Lee, Jae-Wook (Department of Pediatrics, College of Medicine, The Catholic University of Korea)
Lee, Dae-Hyoung (Department of Pediatrics, College of Medicine, The Catholic University of Korea)
Kwon, Young-Joo (Department of Pediatrics, College of Medicine, The Catholic University of Korea)
Park, Young-Shil (Department of Pediatrics, College of Medicine, Kyung Hee University)
Hwang, Hui Sung (Department of Pediatrics, College of Medicine, The Catholic University of Korea)
Kim, Sun Young (Department of Pediatircs, College of Medicine, Chungnam National University)
Park, Ji Kyoung (Department of Pediatrics, Busan Paik Hospital, College of Medicine, Inje University)
Jang, Pil-Sang (Department of Pediatrics, College of Medicine, The Catholic University of Korea)
Jung, Min-Ho (Department of Pediatrics, College of Medicine, The Catholic University of Korea)
Chung, Nak-Gyun (Department of Pediatrics, College of Medicine, The Catholic University of Korea)
Jeong, Dae-Chul (Department of Pediatrics, College of Medicine, The Catholic University of Korea)
Cho, Bin (Department of Pediatrics, College of Medicine, The Catholic University of Korea)
Kim, Hack-Ki (Department of Pediatrics, College of Medicine, The Catholic University of Korea)
Lee, Byung-Churl (Department of Pediatrics, College of Medicine, The Catholic University of Korea)
Publication Information
Clinical and Experimental Pediatrics / v.49, no.11, 2006 , pp. 1211-1215 More about this Journal
Abstract
Purpose : In this study, we analyzed the short term changes of thyroid function, incidence and risk factors of thyroid dysfunction soon after allogeneic hematopoietic stem cell transplantation (HSCT) in children. Methods : We enrolled 80 pediatric patients following allogeneic HSCT, at the Catholic HSCT center between January, 2004 and February, 2006. Serum TSH (thyroid stimulating hormone), total serum thyroxine and total serum triiodothyronine levels were systematically measured in 80 patients before the HSCT, and at 1 month, 6 months and 12 months after HSCT. Results : Thyroid function statistically decreased at 1 month after HSCT(P<0.001). Thyroid dysfunction at 1 month was observed in 43 (54 percent) of 80 patients, 31 (39 percent) of whom presented with euthyroid sick syndrome (ETS). Thyroid dysfunction was normalized within 1 year after HSCT. In univariate analysis, malignant disease and the presence of acute graft-versus-host disease (grade ${\geq}II$) were risk factors for ETS (P=0.04, 0.01 respectively). In multivariate analysis, we could not detect an independent risk factor for ETS (P=0.19, 0.06 respectively). Conclusion : The present study suggests that the incidence of thyroid dysfunction is high after allogeneic HSCT. Therefore, regular monitoring of thyroid hormone levels after HSCT is required.
Keywords
Thyroid function; Euthyroid sick syndrome; Hematopoietic stem cell transplantation;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Borgstrom B, Bolme P. Thyroid function in children after allogeneic bone marrow transplantation. Bone Marrow Transplant 1994;13:59-64
2 Katsanis E, Shapiro RS, Robison LL, Haake RJ, Kim T, Peskovitz OH, et al.Thyroid dysfunction following bone marrow transplantation: long-term follow-up of 80 pediatric patients. Bone Marrow Transplant 1990;5:335-40
3 Thomas BC, Stanhope R, Plowman PN, Leiper AD. Endocrine function following single fraction and fractionated total body irradiation for bone marrow transplantation in childhood. Acta Endocrinol(Copenh) 1993;128:508-12
4 Kubota C, Shinohara O, Hinohara T, Hattori K, Yabe H, Kato S, et al. Changes in hypothalamic-pituitary function following bone marrow transplantation in children. Acta Paediatr Jpn 1994;36:37-43   DOI
5 Matsumoto M, Ishiguro H, Tomita Y, Inoue H, Yasuda Y, Shimizu T, et al. Changes in thyroid function after bone marrow transplant in young patients. Pediatr Int 2004;46:291-5   DOI   ScienceOn
6 Lio S, Arcese W, Papa G, D'Armiento M. Thyroid and pituitary function following allogeneic bone marrow transplantation. Arch Intern Med 1988;148:1066-71   DOI
7 Leslie J. Dangerous dogmas in medicine: The nonthyroidal illness syndrome. J Clin Endocrinol Metab 1999;84:151-64   DOI
8 Lee WY, Kang MI, Oh KW, Oh ES, Baek KH, Lee KW, et al. Relationship between circulating cytokine levels and thyroid function following bone marrow transplantation. Bone Marrow Transplant 2004;33:93-8   DOI   ScienceOn
9 Ogilvy-Stuart AL, Clark DJ, Wallace WH, Gibson BE, Stevens RF, Shalet SM, et al. Endocrine deficit after fractionated total body irradiation. Arch Dis Child 1992;67:1107-10   DOI   ScienceOn
10 Vexiau P, Perez-Castiglioni P, Socie G, Devergie A, Toubert ME, Aractingi S, et al. The 'euthyroid sick syndrome':incidence, risk factors and prognostic value soon after allogeneic bone marrow transplantation. Br J Haematol 1993;85:778-82   DOI   ScienceOn
11 Keilholz U, Max R, Scheibenbogen C, Wuster C, Korbling M, Haas R. Endocrine function and bone metabolism 5 years after autologous bone marrow/blood-derived progenitor cell transplantation. Cancer 1997;79:1617-22   DOI   ScienceOn
12 Balduzzi A, Gooley T, Anasetti C, Sanders JE, Martin PJ, Petersdorf EW, et al. Unrelated donor marrow transplantation in children. Blood 1995;86:3247-56
13 Inder J. Euthyroid sick syndrome: Is it a misnomer? J Clin Endocrinol Metab 1997;82:329-34   DOI
14 Michel G, Socie G, Gebhard F, Bernaudin F, Thuret I, Vannier JP, et al. Late effects of allogeneic bone marrow transplantation for children with acute myeloblastic leukemia in first complete remission: the impact of conditioning regimen without total-body irradiation a report from the Societe Francaise de Greffe de Moelle. J Clin Oncol 1997;15:2238-46   DOI
15 Hershman JM, Eriksen E, Kaufman N. Champlin RE. Thyroid function tests in patients undergoing bone marrow transplantation. Bone Marrow Transplant 1990;6:49-51
16 Carlson K, Lonnerholm G, Smedmyr B, Oberg G, Simmonson B. Thyroid function after autologous bone marrow transplantation. Bone Marrow Transplant 1992;10:123-7
17 McIver B, Gorman CA. Euthyroid sick syndrome: an overview. Thyroid 1997;7:125-32   DOI   ScienceOn
18 Mulligan SP, Joshua DE, Joasoo A, Kronenberg H. Autoimmune hyperthyroidism associated with chronic graftversus-host disease. Transplantation 1987;44:463-4   DOI
19 Toubert ME, Socie G, Gluckman E, Aractingi S, Esperou H, Devergie A, et al. Short- and long-term follow-up of thyroid dysfunction after allogeneic bone marrow transplantation without the use of preparative total body irradiation. Br J Haematol 1997;98:453-7   DOI   ScienceOn
20 Al-Fiar FZ, Colwill R, Lipton JH, Fyles G, Spaner D, Messner H. Abnormal thyroid stimulating hormone(TSH) levels in adults following allogeneic bone marrow transplants. Bone Marrow Transplant 1997;19:1019-22   DOI
21 Boulad F, Bromley M, Black P, Heller G, Sarafoglou K, Gillio A, et al. Thyroid dysfunction following bone marrow transplantation using hyperfractionated radiation. Bone Marrow Transplant 1995;15:71-6   DOI   ScienceOn