Clinical and Experimental Pediatrics

대한소아청소년과학회 (The Korean Pediatric Society)
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Risk factors for short term thyroid dysfunction after hematopoietic stem cell transplantation in children

  • Jung, You Jin (Department of Pediatrics, The Catholic University of Korea College of Medicine) ;
  • Jeon, Yeon Jin (Department of Pediatrics, The Catholic University of Korea College of Medicine) ;
  • Cho, Won Kyoung (Department of Pediatrics, The Catholic University of Korea College of Medicine) ;
  • Lee, Jae Wook (Department of Pediatrics, The Catholic University of Korea College of Medicine) ;
  • Chung, Nack-Gyun (Department of Pediatrics, The Catholic University of Korea College of Medicine) ;
  • Jung, Min Ho (Department of Pediatrics, The Catholic University of Korea College of Medicine) ;
  • Cho, Bin (Department of Pediatrics, The Catholic University of Korea College of Medicine) ;
  • Suh, Byung-Kyu (Department of Pediatrics, The Catholic University of Korea College of Medicine)
  • 투고 : 2012.09.14
  • 심사 : 2012.10.23
  • 발행 : 2013.07.15
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초록

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.

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참고문헌

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피인용 문헌

  1. Endocrinopathies in Survivors of Childhood Neoplasia vol.2, pp.None, 2014, https://doi.org/10.3389/fped.2014.00101
  2. Thyroid dysfunction in children with leukemia over the first year after hematopoietic stem cell transplantation vol.31, pp.11, 2018, https://doi.org/10.1515/jpem-2018-0162