Peer-reviewed article
The Effects of Conditioning Regimen on Thyroid Function After Hematopoietic Stem Cell Transplantation in Children: 2-Year Short Term Follow Up
Lee N, Kim S, Kim S, Ahn M, Kim S et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study examined thyroid function in 150 children who received hematopoietic stem cell transplants for blood cancers at a hospital in Seoul. Researchers compared thyroid function before transplant and at 12 and 24 months after transplant across different conditioning regimens (chemotherapy and radiation). The study found that 12.5% of patients developed thyroid dysfunction within 2 years, with higher rates in children who received both total body irradiation and busulfan-based chemotherapy.
Key points
- 150 children (median age 10.5 years) treated for acute leukemia were followed for thyroid function after stem cell transplant
- Thyroid dysfunction occurred in 15 patients (12.5%): 4 with euthyroid sick syndrome, 11 with subclinical hypothyroidism, and 1 with high T4 syndrome
- Children receiving both TBI and busulfan-based conditioning had significantly higher rates of thyroid dysfunction than other regimens (p = 0.033)
- TBI combined with busulfan was identified as a risk factor for thyroid dysfunction at 2 years post-transplant
Limitations
This is a retrospective chart review with no control group, so causation cannot be established and unmeasured confounding factors may explain the associations. The follow-up period is limited to 2 years, which may not capture longer-term thyroid complications.
Abstract
Abstract Background: Long term effect of conditioning regimen such as Total body irradiation (TBI) and chemotherapy has been studied. However short term effect of conditioning regimen on endocrinologic system was not well known. Purpose. Our study aimed to evaluate the effect of conditioning regimen on thyroid function in children who had HSCT after 2 years. Methods:. Date was obtained from retrospective review of medical records who treated malignant hematologic disease and transplanted hematopoietic stem cell in Seoul St. Mary’s hospital from January 1, 2010 to August 31, 2018. Among 563 patients who underwent HSCT for about 9 years, we studied 150 patients who conforming to inclusion criteria of this study. Thyroid function was tested before HSCT and follow 12 and 24 months. Anthropometric date, duration of chemotherapy, history of relapse, graft versus host disease (GVHD) were also analyzed. Results: In patient’s characteristics, median age at HSCT was 10.49 (0.89 - 19.29) years. Out of 150 patients, male was 92 and female was 58. Acute lymphoid leukemia (ALL) was 74, acute myeloid leukemia (AML) was 76. Among them, busulfan based conditioning was done in 53 patients, TBI based conditioning regimen used in 72 and 25 patients had done TBI with busulfan based conditioning regimen. Fifteen patients (12.5%) had thyroid dysfunction after 2 years of HSCT (4 euthyroid sick syndrome, 11 subclinical hypothyroidism and 1 high T4 syndrome). Incidence of thyroid dysfunction by conditioning regimen was different at 2 years after HSCT, higher in TBI with busulfan based group (p = 0.033). In univariate regression analysis, using conditioning regimen, by TBI with busulfan was risk factor of thyroid dysfunction at 2 years after HSCT. Conclusions: TBI with busulfan based group showed higher incidence of thyroid dysfunction and conditioning regimen was risk factor of thyroid dysfunction at 2 years after HSCT.