Prolonged chronic graft-versus-host disease is a risk factor for thyroid failure in long-term survivors after matched sibling donor stem cell transplantation for hematologic malignancies.
We studied thyroid function in 81 long-term survivors of allogeneic stem cell transplantation (allo-SCT), with a median follow-up of 84 months (range, 45 to 166 months). Median age at transplantation was 35 years (range, 6 to 66). Seventy-two of the patients received a total body irradiation (TBI)-containing conditioning regimen (n = 23, 12 Gy; n = 49, 13 Gy). Twenty-one of the patients (25.9%) had subclinical hypothyroidism, and 9 (11.1%) developed overt hypothyroidism at a median of 28 months (range, 3 to 78 months) after allo-SCT. Multivariate logistic regression analysis demonstrated that prolonged immunosuppressive therapy (IST) was significantly associated with subclinical hypothyroidism (odds ratio [OR] = 3.8) and overt hypothyroidism (OR = 2.6). Antithyroglobulin and thyroid peroxidase antibody were detected in 12 of 60 patients tested (20%). No correlation was found between the occurrence of thyroid antibodies and hypothyroidism (P = .13) or chronic graft-versus-host disease (cGVHD) (P = .55). In conclusion, thyroid dysfunction is relatively common after allo-SCT and is more likely to occur in patients receiving prolonged IST for cGVHD; however, thyroid dysfunction does not appear to be related to an antibody-mediated autoimmune process.
Savani
Bipin N
BN
Stem Cell Transplantation Section, Hematology Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA.
Koklanaris
Eleftheria K
EK
Le
Quan
Q
Shenoy
Aarthi
A
Goodman
Stacey
S
Barrett
A J
AJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D001323:Autoantibodies / Q000096:biosynthesis; D002648:Child; D005260:Female; D006086:Graft vs Host Disease / Q000188:drug therapy / Q000276:immunology / Q000503:physiopathology*; D019337:Hematologic Neoplasms / Q000188:drug therapy / Q000628:therapy; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007037:Hypothyroidism / Q000209:etiology* / Q000276:immunology; D008297:Male; D008875:Middle Aged; D017741:Survivors; D013961:Thyroid Gland / Q000276:immunology / Q000378:metabolism / Q000503:physiopathology*; D019172:Transplantation Conditioning; D014916:Whole-Body Irradiation; D055815:Young Adult
D001323:Autoantibodies