ESPE Abstracts (2015) 84 P-3-818

Endocrine Evaluation in Children and Adolescents Submitted to Allogeneic Bone Marrow Tranplantation

Hilton Kuperman, Thais Della Manna, Vaê Dichtchkenian, Hamilton Cabral de Menezes Filho, Leandra Steinmetz, Louise Cominato, Juliana Folloni Fernandes, Angela Mandelli, Luiz Fernando Mantovani, Maria Aparecida Zanichelli, Maria Dulce Colassanti, Lilian Maria Cristófani, Vicente Odone Filho & Durval Damiani


Faculdade de Medicina USP, Instituto da Criança Hospital das Clinicas, São Paulo, Brazil


Background: Paediatric bone marrow transplantation (BMT) can lead to endocrine dysfunctions due to common pre-procedure protocols involving chemo and radiotherapy.

Objective and hypotheses: To evaluate the prevalence and time-of-onset of endocrine dysfunctions after BMT in children and adolescents.

Method: A retrospective cohort-study design was performed. The inclusion criteria were: age range less than 18 years old at the time of their allogenic BMT program, which started in 2010 in our Institution. The patients started their follow-up 100 days after BMT (time zero) and every six months, when possible. Height (cm), Weight (Kg), BMI and respective z-scores (NCHS 2000) as well as their pubertal status (Tanner) were obtained. Lab and imaging data for endocrine diseases (GH deficiency; precocious/delayed puberty, thyroid dysfunctions, adrenal diseases, diabetes insipidus, bone diseases, and metabolic syndrome) were collected.

Results: From 75 patients submitted to allogeneic BMT, 40 (21 females) were referred to endocrine evaluation. Their primary disease was diagnosed at 5.5 (±4.2) years old (Range: 0.0–15.0). BMT was performed at 8.5 (±4.5) ys (0.8–17.8). Bone marrow donors were: siblings (21), bone bank (nine), umbilicus cord (five), and parents (five). The patients were referred for endocrine evaluation at 9.9 (±4.4) ys (2.0–18.0). The prevalence of endocrine complications was: Growth disorders ((8), five with GH deficiency, under treatment), hypothyroidism (five) dyslipidemia (five), amenorrhea (three), obesity (two), puberty disorders (three), failure to thrive (one). 15 patients have been still under follow-up with no endocrine disease detected so far.

Conclusion: These findings emphasise the importance of screening for endocrine complications in children and adolescents submitted to BMT, particularly growth, thyroid and metabolic. Children require an early and long follow up so that endocrine complications can be diagnosed and promptly treated.