Endocrine function and bone metabolism 5 years after autologous bone marrow/blood-derived progenitor cell transplantation.
BACKGROUND
High dose chemotherapy with or without total body irradiation supported by autologous transplantation of hematopoietic progenitor cells is increasingly being used for hematologic and solid tumors. However, there is only limited information available on late toxicity.


METHODS
The authors investigated endocrine function and bone metabolism in 29 patients with a median interval of 5 years after autografting.


RESULTS
In accordance with an earlier report on this patient cohort, ovarian failure was observed to be unchanged, except for one woman with recovered ovarian function who gave birth to two healthy children. In two-thirds of the men, follicle-stimulating hormone levels were elevated, suggesting germinal aplasia. Determination of bone mineral density did not reveal osteopenia, despite several risk factors: prolonged immobilization, high dose corticosteroid treatment, and, in women, transient estrogen insufficiency. Frequent impairment of thyroid function has been reported in patients receiving single dose total body irradiation. Overt or subclinical hypothyroidism was not detected, most likely because the total body irradiation was hyperfractionated.


CONCLUSIONS
With the exception of gonadal failure, no significant late effects on endocrine function or bone metabolism were observed in this patient cohort.
Keilholz
U
U
Department of Medicine V (Hematology/Oncology), University of Heidelberg, Germany.
Max
R
R
Scheibenbogen
C
C
Wüster
C
C
Körbling
M
M
Haas
R
R
D000324:Adrenocorticotropic Hormone / Q000097:blood*; D000328:Adult; D016026:Bone Marrow Transplantation; D001842:Bone and Bones / Q000378:metabolism*; D002118:Calcium / Q000378:metabolism; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006065:Gonadotropins, Pituitary / Q000097:blood*; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D012737:Sex Factors; D013739:Testosterone / Q000097:blood*; D013972:Thyrotropin / Q000097:blood; D019172:Transplantation Conditioning / Q000009:adverse effects* / Q000379:methods; D014182:Transplantation, Autologous
D006065:Gonadotropins, Pituitary; D013739:Testosterone; D000324:Adrenocorticotropic Hormone; D013972:Thyrotropin; D002118:Calcium