Changes in thyroid function parameters 3 months after allogeneic and autologous hematopoietic stem cell transplantation in children

Author:

Lebbink Chantal A12ORCID,Bresters Dorine3,Tersteeg Joni P B1,van den Bos Cor2,Dierselhuis Miranda P2,Lentjes Eef G W M4,Verrijn Stuart Annemarie A1,Fiocco Marta25,Tissing Wim J E26,van Santen Hanneke M12ORCID

Affiliation:

1. Department of Pediatric Endocrinology, Wilhelmina Children's Hospital, University Medical Center Utrecht , Utrecht , The Netherlands

2. Princess Máxima Center for Pediatric Oncology , Utrecht , The Netherlands

3. Stem Cell Transplantation Unit, Princess Máxima Center for Pediatric Oncology , Utrecht , The Netherlands

4. Laboratory Clinical Chemistry and Hematology, University Medical Center Utrecht , Utrecht , The Netherlands

5. Mathematical Institute Leiden University, The Netherlands and Department of Biomedical Science, Section Medical Statistics, Leiden University Medical Centre , Leiden , The Netherlands

6. Department of Pediatric Oncology, University of Groningen, University Medical Center Groningen , Groningen , The Netherlands

Abstract

Abstract Background Thyroid dysfunction (hypo- and hyperthyroidism) has been reported as a late effect after hematopoietic stem cell transplantation (HSCT) in children. Short-term effects of HSCT on thyroid function parameters are, however, unclear. Methods We prospectively evaluated thyroid function parameters before and 3 months after HSCT in all children (<21 years) who underwent HSCT during a 2-year period in the Princess Máxima Center, the Netherlands. Results Among 72 children, none had thyroidal hypothyroidism or hyperthyroidism 3 months after HSCT. Changes in thyroid function parameters (either aberrant thyroid-stimulating hormone [TSH] or free thyroxine [FT4] concentrations) were found in 16% before and in 10% 3 months after HSCT. Reverse triiodothyronine (rT3) was found elevated in 9.3% before and in 37% 3 months after HSCT, which could be related to poor physical condition. An individual decline in FT4 concentration of ≥20% was found in 10.5% (6/57) 3 months after HSCT. Conclusion In conclusion, thyroidal hypo- and hyperthyroidism are very rare 3 months after HSCT. These results indicate that surveillance for hypo- and hyperthyroidism may start later in time. The changes in thyroid function parameters found 3 months after HSCT might reflect euthyroid sick syndrome.

Funder

Stichting Kinderen Kankervrij

Publisher

Oxford University Press (OUP)

Subject

Endocrinology,General Medicine,Endocrinology, Diabetes and Metabolism

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