ESPE Abstracts

Introduction: Childhood cancer survivors (CCSs) has increased risk of endocrine complications, of which, abnormal growth and hypothyroidism are the commonest. The risk of developing endocrinopathy will vary according to different host factors including type of tumour and factors related to treatment modalities including chemotherapy, radiotherapy, surgery and bone marrow transplantation. we aim to assess the prevalence and associated risk factors of early development of endocrinopathies, namely; abnormal growth and hypothyroidism among CCSs throughout a 5-year follow-up period after exposure to therapy.

Methods: A chart review retrospective cohort study (2015 – 2021) to assess the prevalence and risk of development of abnormal growth and hypothyroidism in CCS during the first 5-year follow-up period after exposure to therapy. We used the health medical informatics system records of all CCSs to scrutinize our data that was analyzed using SPSS V23.

Results: The study recruited 220 children (1-5 (41%), 5-12 (27%) and above 12 years (33%), Males=113, 51%) The main variables were height velocity and BMI (growth) and tumor type (hematological (52.3%) and solid tumors) and hypothyroidism. Hypothyroidism developed in (n=30/220, 14%), height velocity less than 4 cm (n=98/220, 45.8%) and overweight/obesity developed in 32% (n=69/220) of CCSs. The study showed that children above 12 years had increased risk of developing hypothyroidism (P-value=0.004). No gender significant difference although more boys were affected. The height velocity < than 4 cm /year was significantly affected in the first 3 years (P- value=0.013, <0.001, 0.009 in each year, respectively). The modality of intervention associated with highest prevalence of hypothyroidism was the bone marrow transplantation (BMTx) (33%, P-value <0.001). The risk associated with the development of height velocity < 4 cm/year was also the highest in children older than 12 years. They were more affected in the first year in both the hematological and solid tumors, and also post corticosteroids and radiotherapy (P-values =0.017, 0.024, 0.039, 0.006, respectively). Height velocity was affected late in post BMTx, in the second- and third-years post treatment (P values= 0.006 and 0.034, respectively). The risk factors associated with development of overweight (n=16, 7.2%) and obesity (n=30/220, 13.6%) was significant post chemotherapy in third- and fourth-years post intervention (P-value=0.41).

Conclusion: The risk of developing early endocrinopathy was more apparent in the first 3 years post therapy and older age group was the more vulnerable in our cohort. Bone marrow transplantation was the most intervention associated with endocrine complications.