Normal long-term parathyroid function after autologous bone marrow transplantation in children

Area of Science:

• Pediatric Hematology
• Endocrinology
• Transplantation Medicine

Background:

• Parathyroid function alterations are reported in pediatric bone marrow transplant (BMT) patients, particularly those conditioned without irradiation.
• Understanding parathyroid hormone (PTH) levels is crucial for managing pediatric BMT survivors.

Purpose of the Study:

• To investigate parathyroid function in children with malignant hematological diseases following autologous BMT.
• To compare parathyroid function in patients conditioned with chemotherapy alone versus those receiving total body irradiation (TBI).

Main Methods:

• Analysis of PTH, albumin-corrected serum calcium, and serum phosphate in 35 pediatric BMT patients.
• Follow-up duration ranged from six months to nine years post-BMT.
• Patients were stratified into groups based on conditioning regimens (chemotherapy alone vs. TBI, with or without prior cranial radiation therapy [CRT]).

Main Results:

• Normal PTH levels were observed in most pediatric BMT patients.
• Transient PTH elevation occurred in 11% of patients within the first year post-BMT.
• No significant differences in PTH levels were found between irradiated and non-irradiated groups.
• Serum calcium remained unchanged, while serum phosphate showed a slight decrease.
• Renal function showed a slight, non-significant decrease but remained within normal limits.

Conclusions:

• Parathyroid function is generally normal in pediatric patients after autologous BMT.
• Irradiation (TBI or CRT) does not appear to significantly impact parathyroid function in this cohort.
• Transient PTH elevations may occur in a small percentage of patients during the initial year post-BMT.