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ENDOCRINE COMPLICATIONS IN PATIENTS WITH GVHD
Summary
Graft-versus-host disease (GVHD) after hematopoietic stem cell transplantation (HST) can cause endocrine issues like growth impairment and adrenal insufficiency. Early monitoring and treatment of these complications are crucial for patient outcomes.
Area of Science:
- Endocrinology
- Hematology
- Immunology
Background:
- Graft-versus-host disease (GVHD) affects 30-70% of patients post-allogeneic hematopoietic stem cell transplantation (HST).
- Chronic GVHD often requires prolonged immunosuppressive therapy, including corticosteroids.
- Endocrine manifestations can stem from HST, its treatments, or GVHD itself.
Purpose of the Study:
- To review endocrine complications following HST.
- To examine manifestations arising from the primary disease, treatments (chemotherapy, radiation, corticosteroids), or GVHD.
Main Methods:
- Conducted a narrative review of GVHD post-HST.
- Performed an English-language PubMed search (inception to August 2018).
- Utilized search terms: "endocrine complications," "bone marrow transplantation," "graft-versus-host disease," and "GVHD."
Main Results:
- Chronic GVHD is linked to pediatric growth impairment and thyroid dysfunction/cancer.
- Increased risks observed for low bone mineral density (BMD), reduced fertility, and metabolic syndrome.
- Suppression of the pituitary-adrenal axis leading to adrenal insufficiency is a significant concern.
Conclusions:
- Monitoring and treating endocrine complications post-HST are vital.
- Further research is needed to clarify GVHD's independent impact on the endocrine system.
- Investigating specific treatments for these endocrine complications is essential.
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