Purpose: In this study, we analyzed the short term change of thyroid function, incidence and risk factors of thyroid dysfunction soon after allogeneic hematopoietic stem cell transplantation(HSCT) in children.

Method: We enrolled 80 pediatric patients following allogeneic HSCT, at the Catholic HSCT center between January, 2004 and February, 2006. Serum TSH(thyroid stimulating hormone), total serum thyroxine, total serum triiodothyronine levels were systematically measured in 80 patients before and 1 month, 6 month and 12 month after HSCT.

Results: Thyroid function was statistically decreased at 1 month after HSCT(P < 0.001). Thyroid dysfunction at 1 month was observed in 43(54%) of 80 patients, 31(39%) of whom presented with euthyroid sick syndrome. Thyroid dysfunction was normalized within 1 year after HSCT(Table).

In univariate analysis, malignant disease and presence of acute GvHD(grade ≥II) were risk factors for euthyroid sick syndrome(P = 0.04, 0.01). In multivariate analysis, we could not detect an independent risk factor for euthyroid sick syndrome(P = 0.19, 0.06).

Conclusion: The present study suggests that the incidence of thyroid dysfunction is high after allogeneic HSCT. Therefore, regular monitoring of thyroid hormone levels after HSCT is required.

Short-term changes in thyroid function after HSCT

Pre HSCTPost HSCT 1 monthPost HSCT 6 monthPost HSCT 12 month
T3 (ng/dL) 161 ± 27 100 ± 35 123 ± 35 124 ± 35 
T4 (μg/dL) 8.7 ± 1.6 6.5 ± 2.4 7.3 ± 1.8 7.7 ± 1.6 
TSH (mIU/L) 2.9 ± 1.9 1.2 ± 1.3 2.4 ± 1.8 2.1 ± 1.3 
Pre HSCTPost HSCT 1 monthPost HSCT 6 monthPost HSCT 12 month
T3 (ng/dL) 161 ± 27 100 ± 35 123 ± 35 124 ± 35 
T4 (μg/dL) 8.7 ± 1.6 6.5 ± 2.4 7.3 ± 1.8 7.7 ± 1.6 
TSH (mIU/L) 2.9 ± 1.9 1.2 ± 1.3 2.4 ± 1.8 2.1 ± 1.3 
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Topics:
allogeneic hematopoietic stem cell transplant, child, euthyroid sick syndrome, hematopoietic stem cell transplantation, thyroid diseases, thyroid function tests, thyrotropin, cancer, graft-versus-host disease, acute, serum thyroxine test

Disclosure: No relevant conflicts of interest to declare.

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Corresponding author

2006, The American Society of Hematology
2006
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