Incidence and Predicting Factors for Abnormal Thyroid Function Test in Adult Patients Post Hematopoietic Stem Cell Transplantation at King Hussein Cancer Center
Journal Title: Journal of Endocrinology and Diabetes - Year 2016, Vol 3, Issue 4
Abstract
Introduction: The risk of abnormal thyroid function after hematopoietic stem cell transplantation (HSCT) is well-known especially in pediatric patients. There are few studies about adult patients that showed 3-year cumulative incidence ranges between 8-23%. In this study we studied the incidence of abnormal thyroid function in patients older than 18 years, and reviewed its predicting factors. Patients and Method: This is a retrospective study for all adult patients who underwent HSCT at KHCC from 2004-2010.Our cohort consisted of 108 patients who had normal thyroid function before transplant, and at least one Thyroid Function Test (TFT) done after transplant. From the group 54.8% had autologous transplant, 45.2% had allogenic transplant from which 94.6% had myeloablative transplant. Total Body Irradiation (TBI) was used in the conditioning regimen in 29% of the patients. Results: At a median follow up of 1.1 year (0.1-6.1 years), 34 patients (31%) developed abnormal thyroid function tests, high TSH accounted for 40.7%, low TSH for 38.9%, low T4 for 11.1%, and high TSH with low T4 for 3.7%. The factors that showed significant correlation with Abnormal Thyroid Function (ATF) were: Female gender, allogenic transplant, and TBI-based conditioning. From the 34 patients who developed abnormal test after transplant, 61.7% of them developed thyroid dysfunction in the first year post transplant, and 20.5% in the second year. Conclusion: The incidence of abnormal thyroid function for adult patients after HSCT is around 30%. Most of the abnormalities happened in the first 2 years after transplant. Female gender, allogenic transplant, and TBI-based conditioning were associated with more occurrences of thyroid function abnormalities.
Authors and Affiliations
Enas F Younis, Fawzi A. Abdel-Rahman, Ayad A. Hussein, Husam A. Abu-Jazar, Abdulhadi I. Al-Zaben, OmarZ. Al-Rawi, Adnan M. Saad, Nilly N. Hussein
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