Submitted August 13, 2008
Accepted September 14, 2008
Thyroid function following hematopoietic cell transplantation in children: 30 years experience
Jean E. Sanders*, Paul A. Hoffmeister, Ann E. Woolfrey, Paul A. Carpenter, Barry E. Storer, Rainer F. Storb, and Frederick R. Appelbaum
Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, United States
* Corresponding author; email: jsanders{at}fhcrc.org.
Thyroid dysfunction is a known complication following hematopoietic cell transplantation (HCT) in children with reports involving relatively short follow-up and small patient numbers. This study involves 791 patients <18 years of age at HCT at the Fred Hutchinson Cancer Research Center with follow-up from 1969 through 2007. Thyroid dysfunction continued for 28 years after transplantation. Hypothyroidism was the most common abnormality with other abnormalities of hyperthyroidism and thyroiditis. Multivariate analysis showed that thyroid dysfunction was more likely if patients were <10 years of age (P = 0.0001) but there was no difference between receiving a total body irradiation or busulfan based regimens (P = 0.48) compared to cyclophosphamide conditioning alone (P = 0.008). Thyroid tumors occurred at a median of 9.9 (4.5-22.3) years after HCT and included 13 with papillary carcinoma and 5 with benign adenomas. Children who receive a HCT should be monitored for thyroid abnormalities throughout life.
