ESPE Abstracts (2021) 94 FC9.6

ESPE2021 Free Communications Growth Hormone and IGFs (6 abstracts)

Impact of pre-transplant serum-IGF-1 on hematopoietic stem cell transplantation outcome in pediatric cancer patients

Deborah Betzmann 1 , Michaela Döring 1 , Gunnar Blumenstock 2 , Friederike Erdmann 3 , Desiree Grabow 3 , Peter Lang 1 & Gerhard Binder 1

1University-Children’s Hospital, Tübingen, Germany.;2Department of Clinical Epidemiology and Applied Biometry, University of Tübingen, Tübingen, Germany.;3German Childhood Cancer Registry, Mainz, Germany

Background: Hematopoietic stem cell transplantation (HSCT) is associated with severe medical complications and variable outcome depending on the recipient’s disease stage and health condition. As serum-IGF 1 is decreased in patients with severe illness, after major surgery, in malnutrition, and other conditions that cause catabolic metabolism, it may serve as predictive biomarker for transplant outcome.

Individuals and Methods: Based on patient records, laboratory files, and follow-up data from the German Childhood Cancer Registry, we evaluated the impact of pre-transplant serum-IGF 1 on both survival and adverse events in 587 pediatric cancer patients, who underwent autologous or allogeneic HSCT (in an age < 19 years) in 1987-2014 at the University Children’s Hospital Tübingen, Germany. Serum IGF 1 was measured by an in-house RIA (mean interassay CV 8.9%), which remained the same over the entire observation period.

Results: Mean pre-transplant IGF 1 (n = 498) was low: -1.67 SDS (SD, 1.54). Completeness of follow-up three and ten years post HSCT was 96 % and 83 % respectively. The ten-year overall survival was 44.8 % (95 % confidence interval [CI], 40.6-48.9). From IGF-1 SDS Quartiles 1 to 4, there was a significant decline of transplant-related mortality (p = 0.0265), veno-occlusive disease (12; 12; 1; 3 %; P < 0.001) and thrombotic microangiopathy (5; 2; 0; 0 %; p = 0.004). IGF 1 decile 1 showed a significantly poorer outcome (P = 0.042) with lower median (12 versus 68 months) and ten-year overall survival (37 % versus 52 %) when compared to decile 2-10.

Conclusions: This study indicates pre-transplant serum-IGF 1 as a predictor of survival and selected vascular adverse events after HSCT that may have diagnostic and therapeutic relevance in pediatric cancer care.

Volume 94

59th Annual ESPE (ESPE 2021 Online)

22 Sep 2021 - 26 Sep 2021

European Society for Paediatric Endocrinology 

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