ESPE2023 Poster Category 1 Multisystem Endocrine Disorders (28 abstracts)
Long-term endocrine sequelae after hematopoietic stem cell transplantation in children and adolescents
Ji-Hee Yoon 1 , Yunha Choi 2 , Soojin Hwang 1 , Yena Lee 3 , Ja Hye Kim 1 , Jin-Ho Choi 1 & Han-Wook Yoo 2
1Department of Pediatrics, Asan Medical Center Children’s Hospital, University of Ulsan College of Medicine, Seoul, Korea, Republic of. 2Department of Pediatrics, CHA Bundang Medical Center, CHA University, Gyeonggi-Do, Korea, Republic of. 3Department of Pediatrics, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea, Republic of
Purpose: As the survival rate for pediatric cancers increases significantly with advances in treatment modalities, long-term endocrine complications have also risen. This study investigated the frequencies and risks of endocrine sequelae of childhood cancer survivors after hematopoietic stem cell transplantation (HSCT).
Methods: This study included 200 pediatric patients who underwent HSCT. Clinical and endocrinological findings were collected retrospectively. Median follow-up duration after HSCT was 14 years.
Results: Endocrine complications occurred in 135 patients (67.5%). Children who underwent HSCT at pubertal age (n= 100) were at higher risk of endocrine complications than prepubertal age (79% vs. 56%, P= 0.001). The most common complication was hypogonadism (40%), followed by dyslipidemia (22%). Short stature and diabetes mellitus were more prevalent in the prepubertal group, whereas hypogonadism and osteoporosis were more common in the pubertal group. Female, pubertal age at HSCT, and glucocorticoid use were predictors of increased risk for any complication. Radiation exposure increased the risk of short stature and hypothyroidism. Hypogonadism was significantly associated with female, pubertal age at HSCT, and high-dose radiation. Pubertal age at HSCT also increased the risks of osteoporosis and dyslipidemia.
Conclusions: This study demonstrated that long-term endocrine complications are common after HSCT in children and adolescents. Age at HSCT is a critical factor for endocrine complications after HSCT. These findings suggest that surveillance strategies for endocrine complications in childhood cancer survivors should be specified according to age at HSCT.
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