Risk factors for short term thyroid dysfunction after hematopoietic stem cell transplantation in children.
10.3345/kjp.2013.56.7.298
- Author:
You Jin JUNG
1
;
Yeon Jin JEON
;
Won Kyoung CHO
;
Jae Wook LEE
;
Nack Gyun CHUNG
;
Min Ho JUNG
;
Bin CHO
;
Byung Kyu SUH
Author Information
1. Department of Pediatrics, The Catholic University of Korea College of Medicine, Seoul, Korea. suhbk@catholic.ac.kr
- Publication Type:Original Article
- Keywords:
Hematopoietic stem cell transplantation;
Thyroid dysfunction;
Child;
Graft-vs-host disease;
Euthyroid sick syndrome
- MeSH:
Busulfan;
Child;
Euthyroid Sick Syndromes;
Graft vs Host Disease;
Hematopoietic Stem Cell Transplantation;
Hematopoietic Stem Cells;
Humans;
Hyperthyroidism;
Hypothyroidism;
Logistic Models;
Risk Factors;
Thyroid Gland;
Whole-Body Irradiation
- From:Korean Journal of Pediatrics
2013;56(7):298-303
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: The purpose of this study was to evaluate short-term thyroid dysfunction and related risk factors in pediatric patients who underwent hematopoietic stem cell transplantation (HSCT) during childhood. METHODS: We studied 166 patients (100 boys and 66 girls) who underwent HSCT at the Catholic HSCT Center from January 2004 through December 2009. The mean age at HSCT was 10.0+/-4.8 years. Thyroid function of the patients was tested before and during 3 months of HSCT. RESULTS: Out of 166 patients, 165 (99.4%) underwent allotransplantation. Acute graft-versus-host disease (GVHD, grades II to IV) developed in 76 patients. Conditioning regimens before HSCT include total body irradiation (n=57), busulfan (n=80), and reduced intensity (n=29). Forty-five (27.1%) had thyroid dysfunction during 3 months after HSCT (29 euthyroid sick syndrome [ESS], 6 subclinical hyperthyroidism, 4 subclinical hypothyroidism, 3 hypothyroxinemia, 2 overt hyperthyroidism, and 1 high T4 syndrome). In a univariate logistic regression analysis, age at HSCT (P=0.002) and acute GVHD (P=0.009) had statistically significant relationships with thyroid dysfunction during 3 months after HSCT. Also, in a univariate logistic regression analysis, ESS (P=0.014) showed a strong statistically significant association with mortality. CONCLUSION: In our study 27.1% patients experienced thyroid dysfunction during 3 months after HSCT. Increase in age and acute GVHD may be risk factors for thyroid dysfunction during 3 months after HSCT. There was a significant association between ESS and mortality.
