Recipients of bone marrow transplants may
have abnormalities of thyroid and other endocrine function
(November 2002)
The background of
the study. Bone marrow transplantation is an effective therapy
for several hematologic diseases, but has many complications. In
this study, thyroid and other endocrine function was evaluated in
a group of patients who had received bone marrow transplants.
How the study was done. The study
subjects were 40 patients (21 women, 19 men) with hematologic disease
who received bone marrow cells from their siblings and who were
disease-free one or more years later. Twenty-two patients had acute
leukemia, 16 chronic leukemia, and 2 aplastic anemia. All received
prolonged immunosuppressive drug and glucocorticoid therapy before
and for a prolonged period after transplantation to prevent or treat
rejection of the transplant or graft-versus-host disease, (GVHD)
in which the transplanted cells damage host tissues. The median
duration of follow-up was 38 months (range, 12 to 62).
The results of the study. After
transplantation, 12 patients (30 percent) had some abnormality in
thyroid function. Four patients with chronic GVHD 1 to 4 years after
transplantation had low serum free triiodothyronine concentrations
and normal serum free thyroxine and thyrotropin (TSH) concentrations,
consistent with nonthyroidal illness. Six patients had subclinical
hyperthyroidism when first studied after transplantation; the three
patients studied again later had normal serum TSH concentrations.
Two patients had subclinical hypothyroidism five and six years after
transplantation.
With respect to other hormones, most of the women had permanent
ovarian deficiency, whereas few men had testicular deficiency. No
patient had permanent adrenal insufficiency or growth hormone deficiency,
but 11 patients (28 percent) had low serum insulin-like growth factor
1 concentrations.
The conclusions of the study. Endocrine
dysfunction is common among patients with hematologic diseases treated
with bone marrow transplantation.
The original article. Tauchmanova
L, Selleri C, De Rosa G, Pagano L, Orio F, Lombardi G, Rotoli B,
Colao A. High prevalence of endocrine dysfunction in long-term survivors
afte
|
