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[Thyroid dysfunction after haematopoietic stem cell transplantation during childhood]
C Curtillet1, P Cuadras, E Dore
1Service hématologie pédiatrique du professeur Michel, hôpital Timone-Enfants, 264, rue Saint-Pierre, 13385 Marseille cedex 05, France. Catherine.Curtillet@mail.ap-hm.fr
Summary
Children undergoing bone marrow transplants face a significant risk of developing hypothyroidism, particularly after total body irradiation (TBI). Younger age increases this risk, highlighting the need for vigilant thyroid monitoring post-transplant.
Area of Science:
- Pediatric Endocrinology
- Hematology/Oncology
- Transplantation Medicine
Context:
- Bone marrow transplantation (BMT) is a critical treatment for various pediatric diseases.
- Thyroid dysfunction is a known complication following BMT, but risk factors require further elucidation.
- Conditioning regimens, including total body irradiation (TBI) and chemotherapy, can impact endocrine function.
Purpose:
- To assess the incidence and identify risk factors for thyroid dysfunction in pediatric BMT recipients.
- To compare the risk of hypothyroidism between different conditioning regimens (TBI vs. Busulphan).
- To investigate the influence of age, gender, primary disease, and graft-versus-host disease on thyroid function.
Summary:
- This study evaluated 79 children post-BMT, finding a 36% six-year probability of hypothyroidism.
- Patients receiving TBI had a significantly higher risk (49%) compared to those treated with Busulphan (9%).
- Younger age (<7.7 years) was identified as a significant risk factor for hypothyroidism in the TBI group.
Impact:
- Highlights the substantial risk of hypothyroidism in pediatric BMT survivors, especially post-TBI.
- Identifies younger age as a novel risk factor, necessitating targeted monitoring.
- Recommends long-term thyroid function surveillance for all BMT patients, irrespective of conditioning regimen.