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KMID : 1130320130560070298
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Korean Journal of Pediatrics
2013 Volume.56 No. 7 p.298 ~ p.303
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Risk factors for short term thyroid dysfunction after hematopoietic stem cell transplantation in children
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Jung You-Jin
Jeon Yeon-Jin
Cho Won-Kyoung
Lee Jae-Wook
Chung Nack-Gyun
Jung Min-Ho
Cho Bin
Suh Byung-Kyu
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Abstract
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Purpose: The purpose of this study was to evaluate short term thyroid dysfunction and related risk factors in pediatric patients who underwent hematopoietic stem cell transplantation (HSCT) during childhood.
Methods: We studied 166 patients (100 boys and 66 girls) who underwent HSCT at the Catholic HSCT Center from January 2004 through December 2009. The mean age at HSCT was 10.0±4.8 years. Thyroid function of the patients was tested before and during 3 months of HSCT.
Results: Out of 166 patients, 165 (99.4%) underwent allotransplantation. Acute graft-versus-host disease (GVHD) (grades II to IV) developed in 76 patients. Conditioning regimens before HSCT include total body irradiation (n=57), busulfan (n=80), and reduced intensity (n=29). Forty-five (27.1%) had thyroid dysfunction during 3 months after HSCT (29 euthyroid sick syndrome [ESS], 6 subclinical hyperthyroidism, 4 subclinical hypothyroidism, 3 hypothyroxinemia, 2 overt hyperthyroidism, and 1 high T4 syndrome). In a univariate logistic regression analysis, age at HSCT (P =0.002) and acute GVHD (P =0.009) had statistically significant relationships with thyroid dysfunction during 3 months after HSCT. Also, in a univariate logistic regression analysis, ESS (P =0.014) showed a strong statistically significant association with mortality.
Conclusion: In our study 27.1% patients experienced thyroid dysfunction during 3 months after HSCT. Increase in age and acute GVHD may be risk factors for thyroid dysfunction during 3 months after HSCT. There was a significant association between ESS and mortality.
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KEYWORD
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Hematopoietic stem cell transplantation, Thyroid dysfunction, Child, Graft-vs-host disease, Euthyroid sick syndrome
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