title: Endocrinopathies after allogeneic and autologous transplantation of hematopoietic stem cells.
abstract: Early and late endocrine disorders are among the most common complications in survivors after hematopoietic allogeneic- (allo-) and autologous- (auto-) stem cell transplant (HSCT). This review summarizes main endocrine disorders reported in literature and observed in our center as consequence of auto- and allo-HSCT and outlines current options for their management. Gonadal impairment has been found early in approximately two-thirds of auto- and allo-HSCT patients: 90-99% of women and 60-90% of men. Dysfunctions of the hypothalamus-pituitary-growth hormone/insulin growth factor-I axis, hypothalamus-pituitary-thyroid axis, and hypothalamus-pituitary-adrenal axis were documented as later complicances, occurring in about 10, 30, and 40-50% of transplanted patients, respectively. Moreover, overt or subclinical thyroid complications (including persistent low-T3 syndrome, chronic thyroiditis, subclinical hypo- or hyperthyroidism, and thyroid carcinoma), gonadal failure, and adrenal insufficiency may persist many years after HSCT. Our analysis further provides evidence that main recognized risk factors for endocrine complications after HSCT are the underlying disease, previous pretransplant therapies, the age at HSCT, gender, total body irradiation, posttransplant derangement of immune system, and in the allogeneic setting, the presence of graft-versus-host disease requiring prolonged steroid treatment. Early identification of endocrine complications can greatly improve the quality of life of long-term survivors after HSCT.
authors.affiliation: Department of Sports Science and Wellness, University "Parthenope" Naples, 80133 Naples, Italy ; Sterile Techniques SSD, AOU "S. Giovanni di Dio e Ruggi d'Aragona" Salerno, Salerno, Italy.
authors.forename: Francesco
authors.identifier: 0000-0002-9127-5987
authors.initials: F
authors.lastname: Orio
authors.affiliation: Department of Clinical Medicine and Surgery, University Federico II Naples, 80131 Naples, Italy.
authors.forename: Giovanna
authors.initials: G
authors.lastname: Muscogiuri
authors.affiliation: Unit of Obstetrics and Gynaecology, "Arcispedale Santa Maria Nuova", IRCCS, 42123 Reggio Emilia, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Palomba
authors.affiliation: Hematology and Hematopoietic Stem Cell Transplant Center, Department of Medicine and Surgery, University of Salerno, 84131 Salerno, Italy.
authors.forename: Bianca
authors.initials: B
authors.lastname: Serio
authors.affiliation: Hematology and Hematopoietic Stem Cell Transplant Center, Department of Medicine and Surgery, University of Salerno, 84131 Salerno, Italy.
authors.forename: Mariarosaria
authors.initials: M
authors.lastname: Sessa
authors.affiliation: Hematology and Hematopoietic Stem Cell Transplant Center, Department of Medicine and Surgery, University of Salerno, 84131 Salerno, Italy.
authors.forename: Valentina
authors.initials: V
authors.lastname: Giudice
authors.affiliation: Hematology and Hematopoietic Stem Cell Transplant Center, Department of Medicine and Surgery, University of Salerno, 84131 Salerno, Italy.
authors.forename: Idalucia
authors.initials: I
authors.lastname: Ferrara
authors.affiliation: Hematology and Hematopoietic Stem Cell Transplant Center, Department of Medicine and Surgery, University of Salerno, 84131 Salerno, Italy.
authors.forename: Libuse
authors.initials: L
authors.lastname: Tauchmanovà
authors.affiliation: Department of Clinical Medicine and Surgery, University Federico II Naples, 80131 Naples, Italy.
authors.forename: Annamaria
authors.initials: A
authors.lastname: Colao
authors.affiliation: Hematology and Hematopoietic Stem Cell Transplant Center, Department of Medicine and Surgery, University of Salerno, 84131 Salerno, Italy.
authors.forename: Carmine
authors.initials: C
authors.lastname: Selleri
mesh_terms: D004700:Endocrine System Diseases / Q000209:etiology*; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D007027:Hypothalamic Diseases / Q000209:etiology; D007246:Infertility / Q000209:etiology; D008297:Male; D012307:Risk Factors; D012737:Sex Factors; D013959:Thyroid Diseases / Q000209:etiology; D014182:Transplantation, Autologous / Q000009:adverse effects; D014184:Transplantation, Homologous / Q000009:adverse effects