Risk factors for short term thyroid dysfunction after hematopoietic stem cell transplantation in children

• Published in: Korean journal of pediatrics Vol. 56; no. 7; pp. 298 - 303
• Main Authors: Jung, You Jin, Jeon, Yeon Jin, Cho, Won Kyoung, Lee, Jae Wook, Chung, Nack-Gyun, Jung, Min Ho, Cho, Bin, Suh, Byung-Kyu
• Format: Journal Article
• Language: Korean
• Published: 2013
• Subjects: Thyroid dysfunction; Euthyroid sick syndrome; Graft-vs-host disease; Child; Hematopoietic stem cell transplantation
• ISSN: 1738-1061; 2092-7258

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 $10.0{\pm}4.8$ 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 $T_4$ 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.