Shalitin S, et al. - Researchers assessed endocrine complications in survivors of hematopoietic stem cell transplantation (HSCT) performed during childhood. For the detection of endocrine and metabolic disorders, long-term surveillance was required in patients after HSCT. Nonmyeloablative conditioning regimens could reduce the incidence of these complications.

Methods

• Researchers evaluated endocrine dysfunction and metabolic syndrome parameters by chart review of 178 childhood HSCT survivors (median age at evaluation, 15.5 [range: 3.8–29.8] years; median follow-up, 8.5 [range: 2–23.4] years).

Results

• Researchers identified the following statistically significant associations (p < 0.05 for all): Growth hormone deficiency (17.4%) was correlated with cranial/craniospinal irradiation, total body irradiation (TBI), allogeneic HSCT, and longer follow-up.
• In this study, short adult stature (23.3% of patients who had attained adult height) was associated with cranial/craniospinal irradiation and, in females, with younger age at HSCT.
• In females, primary gonadal failure was more prevalent (52.6 vs 24.1%).
• Primary gonadal failure was correlated with TBI in males and with a primary diagnosis of hematological malignancy in females.
• Hypothyroidism (25.2%) was correlated with previous neck/mediastinal irradiation.
• Obesity (3.9%), type 2 diabetes (2.2%), impaired glucose tolerance (2.8%), and dyslipidemia (18.5%) were identified as metabolic disturbances.
• An association was found between dyslipidemia with a primary diagnosis of hematological malignancy, TBI, and a positive family history of dyslipidemia.
• In patients who had received fludarabine, endocrine dysfunction was found to be less frequent.