Endocrine disorders during the first year after autologous stem-cell transplant.
BACKGROUND
Frequent endocrine disorders have been reported after allogeneic stem-cell transplant, but data on adult survivors of autologous transplants are still scarce.


METHODS
In this prospective study we investigated early (at 3 months) and late (at 12 months) endocrine dysfunctions in 95 consecutive autologous stem-cell transplant recipients (47 men and 48 women) aged 16 to 55 years. The functions of the hypothalamic-pituitary-gonadal/thyroid/adrenal/somatotroph axis were evaluated.


RESULTS
Three months after the transplant, insulin-like growth factor-1 values were below the normal range in 53 patients (56%); 37 of 40 women (93%) of reproductive age experienced precocious ovarian failure; 39 of 46 men (85%) showed high follicular stimulating hormone, and 17 men (37%) showed low testosterone levels. Adrenal insufficiency occurred in 28 patients (30%) during the peritransplant period after corticosteroid withdrawal. Transient subclinical hyperthyroidism was found in 15 patients (16%). Transient "low T(3)" syndrome was revealed in 29 patients (31%). Twelve months after the transplant, insulin-like growth factor-1 values were still low in 36 patients (38%). Menstrual cycles resumed in four women; follicular stimulating hormone, luteinizing hormone, and estradiol levels improved in 10 patients. Testosterone was low in only two men (4%). Seminal analysis revealed azoospermia in 32 (91%) of 35 men examined. Subclinical hypothyroidism was found in 11 patients (12%); eight of them had previously received radiotherapy for the upper half of the body.


CONCLUSIONS
This study documents frequent endocrine disorders during the first year after autologous stem-cell transplant. Despite a tendency to improve, in more than half of the cases, the complications persisted for more than 1 year. Therefore, to diagnose and correct early and late endocrine dysfunctions, endocrine screening is required during the first year in all patients undergoing autografting.
Tauchmanovà
Libuse
L
Department of Molecular and Clinical Endocrinology and Oncology, "Federico II" University of Naples, Italy.
Selleri
Carmine
C
De Rosa
Gennaro
G
Esposito
Mariarosaria
M
Di Somma
Carolina
C
Orio
Francesco
F
Palomba
Stefano
S
Lombardi
Gaetano
G
Rotoli
Bruno
B
Colao
Annamaria
A
D000293:Adolescent; D000328:Adult; D004700:Endocrine System Diseases / Q000209:etiology*; D005067:Euthyroid Sick Syndromes; D005260:Female; D006801:Humans; D007037:Hypothyroidism / Q000209:etiology; D007334:Insulin-Like Growth Factor I / Q000032:analysis; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012074:Remission Induction; D033581:Stem Cell Transplantation / Q000009:adverse effects*
D007334:Insulin-Like Growth Factor I