title: Metabolic syndrome and endocrine dysfunctions after HSCT in children.
abstract: MS and endocrine dysfunction(s) are common well-recognized complications after HSCT. We retrospectively analyzed our data on 160 patients with a median age at transplant of five yr (0.3-23), who had been followed for a median of seven yr (range 3-18) at Nationwide Children's Hospital after transplant. Dyslipidemia and MS were seen in 13% and 7.5% patients, respectively, and 58% of these patients were <20 yr of age. Twelve patients met the criteria for diagnosis of MS, but four of these did not meet the International Diabetic Federation or WHO criteria. Variation in the diagnostic criteria for MS leading to underdiagnosis is discussed. Female gonadal failure (27%) and hypothyroidism (21%) were the most common endocrine dysfunctions, followed by short stature and GH deficiency (17%) each. TBI and younger age at HSCT were associated with the highest burden of long-term effects, and female sex was more significantly associated with MS-related dysfunction (p < 0.05). Uniform diagnostic criteria for MS and close follow-up after transplant are important for the early diagnosis and management of these late effects, thereby improving the overall quality of life of these patients.
authors.affiliation: Department of Hematology/Oncology/BMT, Nationwide Children's Hospital, Columbus, OH 43205, USA. rajinder.bajwa@nationwidechildrens.org
authors.forename: Rajinder
authors.initials: R
authors.lastname: Bajwa
authors.forename: Micah
authors.initials: M
authors.lastname: Skeens
authors.forename: Amy
authors.initials: A
authors.lastname: Garee
authors.forename: Yongjie
authors.initials: Y
authors.lastname: Miao
authors.forename: Sandeep
authors.initials: S
authors.lastname: Soni
authors.forename: Daniel
authors.initials: D
authors.lastname: Pietryga
authors.forename: Thomas
authors.initials: T
authors.lastname: Gross
authors.forename: Amanda
authors.initials: A
authors.lastname: Termuhlen
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D004700:Endocrine System Diseases / Q000150:complications / Q000209:etiology*; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D007223:Infant; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications* / Q000209:etiology*; D015999:Multivariate Analysis; D016896:Treatment Outcome; D055815:Young Adult