title: NCI, NHLBI/PBMTC first international conference on late effects after pediatric hematopoietic cell transplantation: endocrine challenges-thyroid dysfunction, growth impairment, bone health, & reproductive risks.
abstract: The endocrine system is highly susceptible to damage by high-dose chemotherapy and/or irradiation before hematopoietic cell transplantation (HCT) during childhood. The specific endocrine organs most affected by HCT include the thyroid gland, the pituitary, and the gonads. In addition, hormones that support development and stability of the skeletal system are also affected. Insufficiency of thyroid hormone is 1 of the most common late sequelae of HCT, and occurs more often in young children. Deficiency in the pituitary's production of growth hormone is a problem of unique concern to the pediatric population. The reproductive risks of HCT depend on the patient's gender and pubertal status at the time of HCT. Pubertal or gonadal failure frequently occurs, especially in females. Infertility risks for both genders remain high, whereas methods of fertility preservation are limited in all but postpubertal males. Bone health post-HCT can be compromised by low bone mineral density as well as avascular necrosis, but the data on both problems in the pediatric HCT population are limited. In this paper, the current state of knowledge, gaps in that knowledge, and recommendations for future research are addressed in detail for each of these systems.
authors: Division of Pediatric Blood & Marrow Transplant, University of California San Francisco, San Francisco, California, USA.
authors: Christopher C
authors: CC
authors: Dvorak
authors: Clarisa R
authors: CR
authors: Gracia
authors: Jean E
authors: JE
authors: Sanders
authors: Edward Y
authors: EY
authors: Cheng
authors: K Scott
authors: KS
authors: Baker
authors: Michael A
authors: MA
authors: Pulsipher
authors: Anna
authors: A
authors: Petryk
mesh_terms: D000293:Adolescent; D000328:Adult; D001842:Bone and Bones / Q000502:physiology; D002648:Child; D004700:Endocrine System Diseases / Q000209:etiology* / Q000503:physiopathology; D005260:Female; D006130:Growth Disorders / Q000209:etiology* / Q000503:physiopathology; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D008297:Male; D054547:National Cancer Institute (U.S.); D054555:National Heart, Lung, and Blood Institute (U.S.); D012098:Reproduction / Q000502:physiology; D012307:Risk Factors; D013959:Thyroid Diseases / Q000209:etiology / Q000503:physiopathology; D014481:United States; D055815:Young Adult