All issues > Volume 53(3); 2010

Original Article

Korean J Pediatr. 2010;53(3):420-427. Published online March 15, 2010.

Endocrine dysfunction after bone marrow transplantation during childhood and adolescence

Hye Young HY Jin¹, Jin-Ho JH Choi¹, Ho-Joon HJ Im¹, Jong-Jin JJ Seo¹, Hyung-Nam HN Moon¹, Han-Wook HW Yoo¹

¹Department of Pediatrics, Asan Medical Center Children`s Hospital, University of Ulsan College of Medicine, Seoul, Korea

Correspondence Han-Wook HW Yoo ,Email: hwyoo@amc.seoul.kr

Received: January 13, 2010; Revised: February 25, 2010   Accepted: March 2, 2010.

Abstract

Purpose
: Several complications can occur in patients who received bone marrow transplantation (BMT) during childhood and adolescence. This study aims to investigate endocrine dysfunctions after BMT so that better care can be provided to care for long-term survivors of BMT.
Methods
: One hundred patients (61 males, 39 females) were included in this study. Clinical parameters such as initial diagnosis, age at BMT, conditioning regimen, presence of graft-versus-host disease (GVHD), growth pattern, thyroid function, and pubertal status were retrospectively reviewed to evaluate risk factors associated with endocrine dysfunction.
Results
: Height standard deviation score (SDS) at BMT, after 1 year of BMT, and at the last visit were 0.08¡¾1.04, -0.09¡¾ 1.02, and -0.27¡¾1.18, respectively (P=0.001). Height SDS significantly decreased in patients who received total body irradiation (TBI) (P=0.017). One of the patients who received TBI demonstrated growth hormone deficiency. Thirty (31.9%) of 94 patients had compensated hypothyroidism. Incidence of compensated hypothyroidism was higher among those who had GVHD (odds ratio 2.82, P=0.025). Of the 32 patients (17 males, 15 females) who were over 14 years in male and 13 years in female at the last visit, 16 (3 males, 13 females) had increased luteinizing hormone (LH) or follicle-stimulating hormone (FSH). Abnormal elevation of LH or FSH was more common in females (odds ratio 30.3, P=0.001).
Conclusion
: The most common endocrine dysfunction was ovarian insufficiency. Regular check-up for endocrine function needs to be required due to high incidence of endocrine dysfunction in patients with BMT.

Keywords :Bone marrow transplantation, Childhood, Adolescence, Endocrine dysfunction