Thyroid Disorders in Pediatric Long Term Survivors after Hematopoietic Stem Cell Transplantation

• Published in: QJM : An International Journal of Medicine Vol. 116; no. Supplement_1
• Main Authors: Mohamed, Wafaa Ezzat Ibrahim, Sayed, Safa Matboly, Hassan, Marwa Magdy, Soliman, Samia Aboualhaggag
• Format: Journal Article
• Language: English
• Published: 23.08.2023
• ISSN: 1460-2725; 1460-2393
• DOI: 10.1093/qjmed/hcad069.674

Background Thyroid dysfunction is one of the major long term endocrinopathies shown after hematopoietic stem cell transplantation (HSCT), it is usually described after total body irradiation, thyroid dysfunction after the use of chemotherapy only in conditioning regimen was evaluated in our study. Aim of the Study To assess the frequency of thyroid dysfunction after HSCT in children using chemotherapy only in conditioning and to relate the thyroid dysfunction after HSCT to the underlying disease and transplant related factors. Subjects and methods This cross sectional observational study was conducted over 12 months duration, from 1st of September 2020 to 1st of September 2021, at Pediatric Transplant Unit, Children,s hospital, Ain Shams University, on pediatric long term survivors who received HSCT in the duration between 2011 to 2019. They were investigated for thyroid dysfunction by measuring Thyroid-stimulating hormone (TSH), free thyroxine (Free T4) and free triiodothyronine (Free T3), Antithyroglobulin antibody (Anti-TG) and by thyroid US. Results The frequency of thyroid dysfunction among the long term survivors was 30% (6/20) including: subclinical hypothyroidism 50%, subclinical hyperthyroidism 16.7%, primary hyperthyroidism 16.7% and graves’ disease 16.7%. The most common thyroid disorder was subclinical hypothyroidism. No significant correlation was observed between the frequency of thyroid disorders and type of conditioning regimen used (p = 0.16), underlying disease (p = 0.5), age at transplantation(p = 0.35). Also, no significant correlation was observed between the thyroid disorders and graft versus host disease (GVHD) (p = 0.92) or Anti-TG (p = 0.26). Conclusion HSCT recipients had a high frequencyyof thyroid gland disorders, therefore, the thyroid status of each HSCT recipient should be screened before and after transplant. These findings also emphasize the need for long-term monitoring of thyroid function following HSCT.