Endocrine and Metabolic Disorders After Hematopoietic Stem Cell Transplantation Annalisa Paviglianiti Metabolic Diseases in Hematology

Abstract

Chemotherapy treatment and autologous and allogeneic cell transplantations are often complicated by the onset of metabolic and endocrine disorders. Autoimmune disorders, metabolic diseases, and hormonal dysfunctions are some of the endocrine complications observed during or after treatment with immunotherapy (mostly novel agents) and/or chemotherapy conditioning for transplantation. Although successful treatment of the underlying hematological condition often improves the dysfunction, endocrinopathies can have an impact on prognosis and are associated with poor survival; therefore, it is important to detect and treat them as early as possible. An increased incidence of cardiovascular diseases and metabolic syndrome has been observed after transplantation mostly in longterm survivors. In addition, chemotherapy and radiation along with the prolonged use of corticosteroids can contribute to the onset of thyroid and gonadal dysfunctions. The aim of this article is to describe metabolic dysfunctions occurring in patients who underwent allogeneic cell transplantation.

Thyroid dysfunctions in adult patients after allogeneic hematopoietic stem cell transplantation

“…This result confirms the importance of testing even over the long term 11 . The most common abnormality was hypothyroidism, in parallel to previous reports 12 . Hyperthyroidism and euthyroid sick syndrome were less frequent, similar to published data, and the detection times after allo‐HSCT were earlier, 13 which might be related to the period of immunologic reconstitution 14 .…”

Association of Insulin-like Growth Factor-1 with Bone Mineral Density in Survivors of Childhood Acute Leukemia

“…Patients treated for acute leukemia may develop various complications after therapy completion owning to the treatment modalities used, such as chemo-or radiotherapy, bone marrow transplantation, and other factors, including nutritional imbalance and changes in lifestyle with reduced exercise [3,25] (Figure S1). After acute leukemia treatment, most patients could experience endocrine and metabolic complications impacting their quality of life throughout their lifetime [26].…”

“…Hypothalamicpituitary dysfunction, adrenal insufficiency, and thyroid disorders commonly occur as well. Osteoporosis due to changes in bone metabolism is also a complication that can arise in survivors of childhood acute leukemia [26].…”