Normal spontaneous cortisol secretion in children after autologous bone marrow transplantation.
OBJECTIVE
To describe spontaneous cortisol secretion in children after autologous bone marrow transplantation (BMT) for acute leukaemia and lymphoma.


METHODS
Spontaneous cortisol secretion was analysed in 39 children before and after BMT. Thirteen patients were conditioned with chemotherapy only (group 1), and 26 patients also with total body irradiation (TBI). In the TBI group, 14 patients had received no additional irradiation (group 2), whereas 12 patients had received cranial irradiation (CRT) previously (group 3).


RESULTS
Before BMT, in comparison with group 1, mean morning cortisol was significantly lower in group 2 (252 vs 415 mmol/l, p = 0.004), but not in group 3 (vs 312 mmol/l, p = 0.12). There was no change in group 1 six months after BMT (to 379 nmol/l), whereas morning cortisol increased significantly in group 2 and group 3 (to 386 and 343 nmol/l, respectively; p < 0.05). The change in mean morning cortisol correlated negatively with pretransplant morning cortisol (r = -0.63, p < 0.001). Neither TBI nor CRT were associated with changes in morning cortisol.


CONCLUSIONS
Spontaneous cortisol secretion is maintained after BMT irrespective of whether cranial or total body irradiation has been given or not.
Frisk
Per
P
Department of Women's and Children's Health, Uppsala University Children's Hospital, University Hospital, Uppsala, Sweden. per.frisk@kbh.uu.se
Gustafsson
Jan
J
Arvidson
Johan
J
D000293:Adolescent; D000367:Age Factors; D016026:Bone Marrow Transplantation / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D019337:Hematologic Neoplasms / Q000453:epidemiology / Q000473:pathology* / Q000628:therapy*; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism*; D008137:Longitudinal Studies; D008297:Male; D018570:Risk Assessment; D012720:Severity of Illness Index; D012737:Sex Factors; D013997:Time Factors; D019172:Transplantation Conditioning; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D014916:Whole-Body Irradiation
D006854:Hydrocortisone