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Thyroid dysfunction in children with leukemia over the first year after hematopoietic stem cell transplantation

  • Yoon-ji Lee , Hyun Young Lee , Moon Bae Ahn , Seong-koo Kim , Won Kyoung Cho EMAIL logo , Jae-Wook Lee , Nack-Gyun Chung EMAIL logo , Bin Cho and Byung-Kyu Suh
Published/Copyright: October 16, 2018
Journal of Pediatric Endocrinology and Metabolism
From the journal Journal of Pediatric Endocrinology and Metabolism Volume 31 Issue 11

Abstract

Background

Thyroid function in children with leukemia during the first year after hematopoietic stem cell transplantation (HSCT) was investigated.

Methods

The medical records of 186 subjects [111 boys and 75 girls; lymphoid=75, myeloid=111; median age at HSCT was 10.7 (0.8–21.8) years old] were reviewed retrospectively.

Results

In children with leukemia, T3 decreased at 1 month (p<0.001) and recovered 9 months to the levels before HSCT. TSH decreased at 1 month (p<0.001), recovered at 3 months and increased at 12 months (p<0.001) to the levels before HSCT. The incidence of euthyroid sick syndrome (ESS, 23.2%, 15.5%, 5.9%, 5.2%, 3.9%, p for trend <0.001) decreased and subclinical hypothyroidism (SH, 0%, 3.9%, 14.8%, 22.1%, 21.3%, p for trend <0.001) increased at 1, 3, 6, 9 and 12 months after HSCT. Out of 55 patients developing ESS during 3 months after HSCT, 54 recovered to normal thyroid function within 5 months without medication. Among the total 186 subjects, 21 patients have been treated with levothyroxine. Both height and weight standard deviation scores continued to decrease over 1 year after HSCT.

Conclusions

In children with leukemia, one-quarter had ESS at 1 month and one-fifth had SH at 12 months and continued growth impairments were observed during 1 year after HSCT. Most of the ESS patients recovered to normal within 5 months without medication. More long-term follow-up of thyroid function and growth in children with leukemia after HSCT is crucial.

Keywords: children; growth; hematopoietic stem cell transplantation; leukemia; thyroid
Corresponding authors: Won Kyoung Cho, MD, PhD, Department of Pediatrics, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, 93, Jungbudaero (Ji-dong), Paldal-gu, Suwon, Gyeonggi-do 16247, Republic of Korea, Phone: +82-31-249-8312, Fax: +82-31-257-9311; and Nack-Gyun Chung, MD, PhD, Department of Pediatrics, College of Medicine, Seoul St. Mary’s Hospital, The Catholic University of Korea, Banpo-daero 222, Seocho-gu, Seoul 137-701, Republic of Korea, Phone: +82-2-2258-6185, Fax: +82-2-537-6185

Acknowledgments

We thank the department of biostatistics at the Catholic University Graduate School for their help in the statistical analysis.

  1. Author contributions: Yoon-ji Lee, MD; Hyun Young Lee, MD; Moon Bae Ahn, MD were responsible for data collection andprocessing it. Seong-koo Kim, MD; Jae-Wook Lee, MD, PhD developed the theory and verified the analytical methods. Won Kyoung Cho, MD, PhD helped with conception or design of the work and wrote the paper with input from all authors. Nack-Gyun Chung, MD, PhD also helped with the conception or design of the work and wrote the paper with input from all authors. Bin Cho, MD, PhD dealt with conception or design of the work. Byung-Kyu Suh, MD, PhD helped in the critical revision of the article. All authors provided critical feedback and helped shape the research, analysis and manuscript.

  2. Research funding: None declared.

  3. Employment or leadership: None declared.

  4. Honorarium: None declared.

  5. Competing interests: None declared.

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Received: 2018-04-07
Accepted: 2018-09-03
Published Online: 2018-10-16
Published in Print: 2018-11-27

©2018 Walter de Gruyter GmbH, Berlin/Boston

Articles in the same Issue

  1. Frontmatter
  2. Original Articles
  3. Carotid intima media thickness and associations with serum osteoprotegerin and s-RANKL in children and adolescents with type 1 diabetes mellitus with increased risk for endothelial dysfunction
  4. Cardiometabolic risk factors in preschool children with abdominal obesity from Medellín, Colombia
  5. Long-term follow-up of gonadal dysfunction in morbidly obese adolescent boys after bariatric surgery
  6. Prevalence of overweight and obesity and anthropometric reference centiles for Albanian children and adolescents living in four Balkan nation-states
  7. High urate concentration is associated with elevated blood pressure in schoolchildren
  8. The association of hs-CRP and fibrinogen with anthropometric and lipid parameters in non-obese adolescent girls with polycystic ovary syndrome
  9. Leptin and adiposity as mediators on the association between early puberty and several biomarkers in European adolescents: the HELENA Study
  10. Adolescents with premenstrual syndrome: not only what you eat but also how you eat matters!
  11. Thyroid dysfunction in children with leukemia over the first year after hematopoietic stem cell transplantation
  12. Morning vs. bedtime levothyroxine administration: what is the ideal choice for children?
  13. Basal characteristics and first year responses to human growth hormone (GH) vary according to diagnostic criteria in children with non-acquired GH deficiency (naGHD): observations from a single center over a period of five decades
  14. The prevalence and volumetry of pituitary cysts in children with growth hormone deficiency and idiopathic short stature
  15. SHOX gene deletion screening by FISH in children with short stature and Madelung deformity and their characteristics
  16. FGFR3-related hypochondroplasia: longitudinal growth in 57 children with the p.Asn540Lys mutation
  17. Case Reports
  18. A variable course of Cushing’s disease in a 7 year old: diagnostic dilemma
  19. Severe hyperchylomicronemia in two infants with novel APOC2 gene mutation
https://doi.org/10.1515/jpem-2018-0162
Keywords for this article
children; growth; hematopoietic stem cell transplantation; leukemia; thyroid

Articles in the same Issue

  1. Frontmatter
  2. Original Articles
  3. Carotid intima media thickness and associations with serum osteoprotegerin and s-RANKL in children and adolescents with type 1 diabetes mellitus with increased risk for endothelial dysfunction
  4. Cardiometabolic risk factors in preschool children with abdominal obesity from Medellín, Colombia
  5. Long-term follow-up of gonadal dysfunction in morbidly obese adolescent boys after bariatric surgery
  6. Prevalence of overweight and obesity and anthropometric reference centiles for Albanian children and adolescents living in four Balkan nation-states
  7. High urate concentration is associated with elevated blood pressure in schoolchildren
  8. The association of hs-CRP and fibrinogen with anthropometric and lipid parameters in non-obese adolescent girls with polycystic ovary syndrome
  9. Leptin and adiposity as mediators on the association between early puberty and several biomarkers in European adolescents: the HELENA Study
  10. Adolescents with premenstrual syndrome: not only what you eat but also how you eat matters!
  11. Thyroid dysfunction in children with leukemia over the first year after hematopoietic stem cell transplantation
  12. Morning vs. bedtime levothyroxine administration: what is the ideal choice for children?
  13. Basal characteristics and first year responses to human growth hormone (GH) vary according to diagnostic criteria in children with non-acquired GH deficiency (naGHD): observations from a single center over a period of five decades
  14. The prevalence and volumetry of pituitary cysts in children with growth hormone deficiency and idiopathic short stature
  15. SHOX gene deletion screening by FISH in children with short stature and Madelung deformity and their characteristics
  16. FGFR3-related hypochondroplasia: longitudinal growth in 57 children with the p.Asn540Lys mutation
  17. Case Reports
  18. A variable course of Cushing’s disease in a 7 year old: diagnostic dilemma
  19. Severe hyperchylomicronemia in two infants with novel APOC2 gene mutation
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