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Related Experiment Videos

Thyroid and pituitary function following allogeneic bone marrow transplantation.

S Lio1, W Arcese, G Papa

  • 1Institute of Experimental Medicine CNR, Rome, Italy.

Archives of Internal Medicine
|May 1, 1988
PubMed
Summary

Fractionated irradiation in chronic myelogenous leukemia bone marrow transplant patients prevented hypothyroidism. Thyroid function normalized within nine months, showing a selective effect on thyrotropic cells without thyroid cell destruction.

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Area of Science:

  • Endocrinology
  • Hematology
  • Oncology

Background:

  • Allogeneic bone marrow transplantation (BMT) for chronic myelogenous leukemia (CML) often leads to primary hypothyroidism.
  • Fractionated irradiation protocols aim to minimize organ damage compared to single high-dose irradiation.

Purpose of the Study:

  • To evaluate thyroid function in CML patients undergoing BMT with a fractionated irradiation protocol.
  • To determine if this protocol prevents the high incidence of hypothyroidism seen with single-dose irradiation.

Main Methods:

  • Thyroid function tests (plasma thyroxine, triiodothyronine) were performed in 13 CML patients post-BMT.
  • Response of thyrotropic cells to thyrotropin-releasing hormone was assessed.
  • Prolactin and gonadotropin levels were monitored.

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Main Results:

  • Decreased plasma thyroxine and triiodothyronine levels were observed post-BMT.
  • Impaired thyrotropic cell response to thyrotropin-releasing hormone was noted.
  • Thyroid function normalized in nine months; no patients developed permanent hypothyroidism.
  • Selective damage to thyrotropic cells occurred, with normal prolactin and increased gonadotropins.

Conclusions:

  • Fractionated irradiation may prevent permanent primary hypothyroidism after BMT in CML patients.
  • The protocol appears to spare thyroid cells but selectively affects thyrotropic cells.
  • Longer follow-up is required to assess the risk of irradiation-related thyroid tumors.