Endocrine dysfunction after bone marrow transplantation during childhood and adolescence

Abstract

Purpose: Several complications can occur in patients who received bone marrow transplantation (BMT) during childhood and adolescence. This study aims to investigate endocrine dysfunctions after BMT so that better care can be provided to care for long-term survivors of BMT. Methods: One hundred patients (61 males, 39 females) were included in this study. Clinical parameters such as initial diagnosis, age at BMT, conditioning regimen, presence of graft-versus-host disease (GVHD), growth pattern, thyroid func- tion, and pubertal status were retrospectively reviewed to evaluate risk factors associated with endocrine dysfunction. Results :Height standard deviation score (SDS) at BMT, after 1 year of BMT, and at the last visit were 0.08±1.04, -0.09± 1.02, and -0.27±1.18, respectively (P=0.001). Height SDS significantly decreased in patients who received total body irra- diation (TBI) (P=0.017). One of the patients who received TBI demonstrated growth hormone deficiency. Thirty (31.9%) of 94 patients had compensated hypothyroidism. Incidence of compensated hypothyroidism was higher among those who had GVHD (odds ratio 2.82, P=0.025). Of the 32 patients (17 males, 15 females) who were over 14 years in male and 13 years in female at the last visit, 16 (3 males, 13 females) had increased luteinizing hormone (LH) or follicle-stimulating hormone (FSH). Abnormal elevation of LH or FSH was more common in females (odds ratio 30.3, P=0.001). Conclusion :The most common endocrine dysfunction was ovarian insufficiency. Regular check-up for endocrine function needs to be required due to high incidence of endocrine dysfunction in patients with BMT. (Korean J Pediatr 2010;53: 420-427)