Cyclical combination chemotherapy and thyroid function in patients with advanced Hodgkin's disease

Area of Science:

• Endocrinology
• Oncology
• Hematology

Background:

• Hodgkin's disease (HD) is a malignancy of the lymphatic system.
• Thyroid function can be affected by cancer treatments.
• Assessing thyroid health in HD patients is crucial for management.

Purpose of the Study:

• To evaluate clinical and biochemical thyroid function in Hodgkin's disease patients.
• To assess the impact of lymphography, chemotherapy, and irradiation on thyroid function.
• To identify potential thyroid abnormalities during and after HD treatment.

Main Methods:

• Clinical and biochemical thyroid assessments were performed at various time points.
• Thyroid stimulating hormone (TSH) and thyroid releasing hormone (TRH) stimulation tests were utilized.
• Patients were evaluated at diagnosis, post-lymphography, post-chemotherapy, and post-irradiation.

Main Results:

• Elevated TSH levels were observed in 76.5% of patients post-lymphography (median 3 months).
• Chemotherapy did not induce detectable thyroid dysfunction.
• Post-irradiation and chemotherapy, 80% showed abnormal TSH levels, and all had abnormal TRH tests, with 4 clinical dysfunctions.

Conclusions:

• Lymphography can temporarily elevate TSH levels in Hodgkin's disease patients.
• Chemotherapy appears safe regarding thyroid function.
• Irradiation and chemotherapy significantly impact thyroid function, necessitating monitoring.