Endocrine complications of bone marrow transplantation in children

Abstract

Eighty-seven patients had a bone marrow transplantation (BMT) at our institution between 1980 and 1992. We wished to study the endocrine complications that accompany this procedure as long-term survival is now much more common. Forty-three patients were retrospectively available for review and their records were examined for evidence of thyroid, pubertal, and growth complications. Fifteen per cent of the patients showed evidence of thyroid involvement. Pubertal delay or gonadal damage was almost universal in pubertal-aged girls treated with busulfan/cyclophosphamide. Gonadal involvement was more frequent in girls than in boys (70% vs. 47%). Sixty per cent of children were shorter or grew at a slower rate. Sixty-five per cent of the children presented with one or more endocrine complications. These are the combined effects of different treatment regimens (chemotherapy, radiotherapy, combined therapy). It is essential to know the natural history of these patients in order to offer proper guidance and treatment as survival rates are increasing.

Endocrine dysfunction and parameters of the metabolic syndrome after bone marrow transplantation during childhood and adolescence

“…We also found a significant association between final short stature and allogeneic origin of the transplant, as previously described. 5,15 However, this might be explained by the fact that all our patients with Fanconi anemia underwent allogeneic BMT. …”

“…1,2 High rates of skeletal complications, 3 growth disturbances, 4 and thyroid 5,6 and gonadal dysfunction 7 have been described in survivors, although data on the frequency of metabolic syndrome are still sparse. 8 The relative risk of these complications is likely to be influenced by the underlying disease, previous treatments, post-BMT treatments and age at BMT.…”

Dyslipidemia and Metabolic Syndrome in Children and Teenagers After the Allogeneic Hematopoietic Stem Cell Transplantation

“…Нарушение роста наблюдали у 13 % пациентов (из которых 60 % -дети с врожденной костномозговой недостаточностью), что в нашем исследовании встре-чалось реже, чем в других работах (30 % по данным L. Legault et al, 1999) [15], что, скорее всего, обуслов-лено отсутствием ТОТ в режиме кондиционирования, а также использованием РИК у половины пациентов. При оценке соматотропного гормона его уровень был существенно снижен у пациентов с анемией Фанкони, эти дети в основном имели распространенную форму хронической РТПХ и в течение длительного времени получали глюкокортикостероиды, что является фак-тором риска снижения скорости линейного роста.…”

Growth and endocrine function in patients with Hurler syndrome after hematopoietic stem cell transplantation

“…Early diagnosis and replacement of hormonal deficiencies are critical for optimizing growth and development. While many studies have examined long-term growth for other conditions following HSCT, [22][23][24][25][26][27][28] there are few growth data specific to patients with MPS IH. 17,19 Even less is known about endocrine function in patients with MPS IH after HSCT.…”

“…[16][17][18][19][20] HSCT as an intervention, however, compounds the problem of short stature. HSCT has been associated with growth suppression, growth hormone (GH) deficiency, abnormal gonadal and thyroid function, and damage to the epiphyseal growth plate and pituitary gland, [21][22][23][24][25][26][27][28][29] all potential causes of short stature.…”