Thyroid function in leukaemia patients after allogeneic bone marrow transplantation.

Area of Science:

• Endocrinology
• Hematology
• Oncology

Background:

• Allogeneic bone marrow transplantation (BMT) is a critical treatment for various hematologic and oncologic conditions.
• Total body irradiation (TBI) is a common conditioning regimen used prior to BMT.
• The impact of TBI and BMT on endocrine function, particularly thyroid function, requires thorough investigation.

Purpose of the Study:

• To evaluate the short-term and long-term effects of allogeneic bone marrow transplantation with total body irradiation on thyroid function.
• To assess changes in thyroid-stimulating hormone (TSH), triiodothyronine (T3), and thyroxine (T4) levels post-transplantation.
• To identify the incidence of thyroid dysfunction, such as hypothyroidism, following this procedure.

Main Methods:

• Prospective study monitoring thyroid function in 29 patients undergoing allogeneic BMT with TBI.
• Serial measurements of TSH, T3, and T4 levels were performed during the first four weeks post-transplantation.
• Long-term follow-up (3-5 years) was conducted on surviving patients to assess sustained thyroid function.

Main Results:

• Twenty out of 29 patients exhibited a significant decrease in T3 and TSH levels within four weeks post-transplant; T4 levels showed fluctuations.
• In long-term survivors (16 patients), T3 levels returned to normal, T4 levels slightly increased, and TSH levels doubled.
• One patient was diagnosed with hypothyroidism during the follow-up period.

Conclusions:

• Thyroid function is significantly altered following allogeneic BMT with TBI, with initial decreases in key hormones.
• Sustained euthyroidism in the long term may necessitate increased pituitary TSH production to overcome potential thyroid resistance or dysfunction.
• The findings highlight the importance of regular thyroid function monitoring in patients post-BMT to detect and manage potential hypothyroidism.