Endocrine complications of pediatric stem cell transplantation

Area of Science:

• Pediatric Endocrinology
• Hematology/Oncology
• Transplantation Medicine

Background:

• Endocrine and growth abnormalities are frequent complications in pediatric and adolescent stem cell transplant (SCT) survivors.
• These issues significantly impact quality of life and long-term health outcomes.
• Understanding these sequelae is crucial for comprehensive patient management.

Purpose of the Study:

• To summarize the common endocrine and growth abnormalities observed in pediatric/adolescent SCT recipients.
• To identify risk factors associated with these complications.
• To highlight the prevalence and specific types of endocrine dysfunction.

Main Methods:

• Review of existing literature on endocrine and growth outcomes post-SCT in pediatric/adolescent populations.
• Analysis of reported frequencies of specific endocrine abnormalities.
• Identification of correlations between transplant characteristics and endocrine sequelae.

Main Results:

• Impaired linear growth and short stature are linked to younger age at transplant, total body irradiation (TBI), and chronic graft-versus-host disease (GvHD).
• Primary hypothyroidism affects 10-28% of patients after fractionated TBI; autoimmune hyperthyroidism also occurs.
• Gonadal dysfunction is highly prevalent, with most males experiencing oligo-azoospermia and most females developing primary ovarian failure after TBI or specific chemotherapy regimens.
• Bone mineral density is often reduced, increasing future osteoporosis risk.

Conclusions:

• Stem cell transplantation in pediatric/adolescent populations frequently leads to significant endocrine and growth disturbances.
• Risk factors such as age at transplant, irradiation, and GvHD influence the development of these complications.
• Long-term monitoring and management strategies are essential to address hypothyroidism, gonadal dysfunction, and bone health in survivors.