ESPE Abstracts (2014) 82 P-D-1-2-245

Thyroid Dysfunction in Children After Hematopoietic Stem Cell Transplantation: Short Term Follow-Up for 12 Months

Yeon Jin Jeon, In Ah Jung, Shin Hee Kim, Won-Kyoung Cho, Jae-Wook Lee, Kyoung Soon Cho, So Hyun Park, Nak-Gyun Chung, Min-Ho Jung, Bin Cho & Byung-Kyu Suh


Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea


Background: We evaluated 12 months follow-up of thyroid function in patients who underwent hematopoietic stem cell transplantation (HSCT) during childhood and adolescents.

Methods: We studied 83 hematologic-malignancy patients (46 boys and 37 girls, acute lymphoblastic leukemia=25, acute myeloid leukemia=51, chronic myelogenous leukemia=7) who underwent HSCT between January 2006 and December 2011.

The mean age at HSCT was 9.78±4.42 years. Thyroid function of the patients was evaluated before and 1, 3, 6, 9, 12 months after HSCT. The incidence and risk factors of overt hypothyroidism, subclinical hypothyroidism (SH) and euthyroid sick syndrome (ESS) were studied. The effect of conditioning regimen, graft-vs-host disease, use of steroid hormone or other clinical factors on thyroid dysfunction was investigated.

Results: Forty-four patients (53.0%) had thyroid dysfunction during 12 months after HSCT.

Thyroid dysfunction developed in 14 (17.3%), 10 (12.0%), 14 (17.3%) and 21 (24.1%) patients at 1, 3, 6, 9 and 12 months after HSCT. The incidence according to duration increased significantly (P for trend 0.035). ESS developed in 8(9.9%), 5(6.9%), 3(3.7%), 3(3.7%) and 2(2.4%) patients at 1, 3, 6, 9 and 12 months after HSCT. The incidence according to duration increased significantly (P for trend 0.00015). SH developed in 2(2.5%), 2(2.4%), 13(16.0%), 13(15.9%) and 12(14.5%) patients at 1, 3, 6, 9 and 12 months after HSCT. The incidence according to duration increased significantly (P for trend 0.031). A total of 11 patients (13.3%) needed thyroid hormone replacement; ten out of them had SH and one overt hypothyroidism. In univariate analysis, there was no significant risk factor of thyroid dysfunction at 12 months after HSCT.

Conclusion: After HSCT during childhood and adolescence, a significant number of patients experience thyroid dysfunction including ESS and SH. Short-term and continuous follow-up for thyroid function after HSCT is important to provide timely and appropriate treatment.