Hypothyroidism following allogeneic hematopoietic stem cell transplantation for acute myeloid leukemia

Medinger, Michael; Zeiter, Deborah; Heim, Dominik; Gerull, Sabine; Thewis, André; Passweg, Jakob; Nigro, N

doi:10.1016/j.leukres.2017.04.003

Cited by 20 publications

(10 citation statements)

References 28 publications

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“…Based on a few studies in literature, the reported incidence of thyroid dysfunction after alloHCT ranges from 10 to 47% in adults [14][15][16]. Relatively short duration of follow-up and small number of patients contribute to wide variability in incidence of thyroid dysfunction seen in these studies.…”

Section: Discussionmentioning

confidence: 99%

Thyroid dysfunction in adult hematopoietic cell transplant survivors: risks and outcomes

Farhadfar

Stan

Shah

et al. 2018

Bone Marrow Transplant

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The incidence and risk factors for thyroid disorders among adult survivors of allogeneic hematopoietic stem cell transplantation (alloHCT) is not well known. This study evaluated incidence and risk factors of thyroid dysfunction in 259 adult alloHCT recipients who had survived for 2 years or more after transplant. Median follow-up was 4.6 years (range; 2.3 to 15.4 years). The 5-year cumulative incidence of thyroid dysfunction was 30.5% (79 of 259 patients). Majority of thyroid abnormalities were observed beyond 2 years after alloHCT. Subclinical hypothyroidism was the most common thyroid abnormalities accounting for 89% of cases (71 patients). Among these, treatment with thyroid replacement was eventually started in 44% (31 patients). Based on the multivariate analysis, thyroid abnormality was more likely in patients who received high-dose (≥12 Gy) total body irradiation (TBI)-based conditioning regimen compare to low-dose TBI-based (≤500 cGy) and non-TBI-conditioning regimen (p = 0.032). This risk was further augmented directly proportional with the time from alloHCT. These data identify high-dose TBI-conditioning regimen as a risk factor for thyroid dysfunction in adult recipients of alloHCT.

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Section: Discussionmentioning

confidence: 99%

Thyroid dysfunction in adult hematopoietic cell transplant survivors: risks and outcomes

Farhadfar

Stan

Shah

et al. 2018

Bone Marrow Transplant

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“…Thyroid abnormalities are well-described after BMT [38][39][40][41][42][43] and include compensated hypothyroidism (elevated TSH accompanied with normal FT4 levels) and overt hypothyroidism (elevated TSH and low FT4). Approximately 30% of patients develop overt hypothyroidism over a 28-year follow-up period.…”

Section: Discussion Of Patientmentioning

confidence: 99%

“…The patient was diagnosed with hypothyroidism and thyroid hormone replacement therapy was initiated. In addition, the patient had laboratory evidence of dyslipidemia (total cholesterol, 285 mg/dL ; LDL, 192 mg/dL ; high-density lipoprotein, 41 mg/dL [40][41][42][43][44][45][46][47][48][49][50][51][52][53][54][55][56][57][58][59]; triglyceride, 275 mg/dL ), and was managed with cholesterol-lowering medications and diet (Table 3).…”

Section: Patientmentioning

confidence: 99%

How I monitor long-term and late effects after blood or marrow transplantation

Bhatia

Armenian

Landier

2017

Blood

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Blood or marrow transplantation (BMT) is used with curative intent for hematologic malignancies. Conditional on surviving the first 2 years after BMT, 5-year survival generally exceeds 70%. However, the cumulative therapeutic exposures lead to premature onset of chronic health conditions, such that the 15-year cumulative incidence of severe or life-threatening chronic health conditions exceeds 40%, resulting in premature mortality. The high burden of morbidity, coupled with a long latency between BMT and the development of chronic health conditions necessitates life-long risk-based monitoring of the BMT survivors. The issues of how and when to screen BMT survivors for therapyrelated complications and exacerbation of preexisting conditions are important and largely unanswered questions. For BMT survivors, screening recommendations must incorporate risks associated with pre-BMT therapy as well as risks related to transplant conditioning and graft-versus-host disease. Here, we describe our approach to monitoring BMT survivors for risk-based screening and early detection of key late-occurring or long-term complications using patient scenarios to illustrate our discussion. (Blood. 2017;130(11):1302-1314

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“…Multivariate analysis found that chronic GVHD was associated with a higher risk of hypothyroidism together with other endocrine and vascular diseases for related and unrelated survivors compared to siblings [21]. A more recent retrospective study on acute myeloid leukemia patients reported the presence of positive thyroperoxidase antibodies and more than one allogeneic HCT as being the main risk factors for developing clinical hypothyroidism [36]. In addition, several retrospective studies reported prolonged immunosuppressive therapy, HLA B35 of the donor, and female donor to male recipient mismatch as risk factors for hypothyroidism [37].…”

Section: Thyroid Disordersmentioning

confidence: 99%

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

Paviglianiti¹

2019

Tjh

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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.

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Hypothyroidism following allogeneic hematopoietic stem cell transplantation for acute myeloid leukemia

Cited by 20 publications

References 28 publications

Thyroid dysfunction in adult hematopoietic cell transplant survivors: risks and outcomes

Thyroid dysfunction in adult hematopoietic cell transplant survivors: risks and outcomes

How I monitor long-term and late effects after blood or marrow transplantation

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

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