Impact of allogeneic stem cell transplantation on thyroid function

Purpose Primary hypothyroidism is a main endocrine complication after allogeneic stem cells transplantation (allo-SCT) in children, but in adults data on post-SCT hypothyroidism are limited. The aims of this observational, cross-sectional study were to assess the prevalence of hypothyroidism in adult allo-SCT recipients according to time from transplantation, and to identify risk factors. Methods One hundred and eighty-six patients (M 104; F 82; median age 53.4 years) who underwent allo-SCT between January 2010 and December 2017 were enrolled and divided into three groups, according to time from allo-SCT (1–3 years; 3–5 years; > 5 years). Pre-transplant TSH and fT4 levels were available for all patients. After transplantation, TSH, fT4 and anti-thyroperoxidase antibodies (TPO-Ab) were evaluated. Results After a follow-up of 3.7 years, 34 (18.3%) patients developed hypothyroidism, with higher prevalence in females (p < 0.001) and in patients who received matched unrelated donor grafts (p < 0.05). No difference in prevalence was found at different time points. Patients who developed hypothyroidism showed higher rate of TPO-Ab positivity (p < 0.05) and higher pre-transplant TSH levels (median 2.34 µU/ml) compared to those with preserved thyroid function (median 1.53 µU/ml; p < 0.001). Multivariable analysis identified higher pre-transplant TSH levels as a positive predictor of hypothyroidism (p < 0.005). The ROC curve analysis identified a pre-SCT TSH cutoff of 1.84 µU/ml, which can predict hypothyroidism with sensitivity 74.1% and specificity 67.2%. Conclusions About one out of four patients developed hypothyroidism after allo-SCT, with a greater incidence in females. Pre-transplant TSH levels seem to predict the onset of post-SCT hypothyroidism..

Medienart:

E-Artikel

Erscheinungsjahr:

2023

Erschienen:

2023

Enthalten in:

Zur Gesamtaufnahme - volume:46

Enthalten in:

Journal of endocrinological investigation - 46(2023), 9 vom: 08. März, Seite 1825-1834

Sprache:

Englisch

Beteiligte Personen:

Felicetti, F. [VerfasserIn]
Gatti, F. [VerfasserIn]
Faraci, D. [VerfasserIn]
Rosso, D. [VerfasserIn]
Zavattaro, M. [VerfasserIn]
Fortunati, N. [VerfasserIn]
Marinelli, L. [VerfasserIn]
Leone, S. [VerfasserIn]
Gill, J. [VerfasserIn]
Dionisi-Vici, M. [VerfasserIn]
Dellacasa, C. [VerfasserIn]
Busca, A. [VerfasserIn]
Giaccone, L. [VerfasserIn]
Arvat, E. [VerfasserIn]
Bruno, B. [VerfasserIn]
Brignardello, E. [VerfasserIn]

Links:

Volltext [lizenzpflichtig]

Themen:

Adults
Allogeneic stem cell transplantation
Cancer survivorship
Hypothyroidism

Anmerkungen:

© The Author(s), under exclusive licence to Italian Society of Endocrinology (SIE) 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

doi:

10.1007/s40618-023-02039-x

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

OLC2144697019

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