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The risk of abnormal thyroid function after hematopoietic stem cell transplantation (HSCT) is well-known especially in pediatric patients. There are few studies about adult patients that showed 3-year cumulative incidence ranges between 8-23%. In this study we studied the incidence of abnormal thyroid function in patients older than 18 years, and reviewed its predicting factors. Patients and Method: This is a retrospective study for all adult patients who underwent HSCT at KHCC from 2004-2010.Our cohort consisted of 108 patients who had normal thyroid function before transplant, and at least one Thyroid Function Test (TFT) done after transplant. From the group 54.8% had autologous transplant, 45.2% had allogenic transplant from which 94.6% had myeloablative transplant. Total Body Irradiation (TBI) was used in the conditioning regimen in 29% of the patients. Results: At a median follow up of 1.1 year (0.1-6.1 years), 34 patients (31%) developed abnormal thyroid function tests, high TSH accounted for 40.7%, low TSH for 38.9%, low T4 for 11.1%, and high TSH with low T4 for 3.7%. The factors that showed significant correlation with Abnormal Thyroid Function (ATF) were: Female gender, allogenic transplant, and TBI-based conditioning. From the 34 patients who developed abnormal test after transplant, 61.7% of them developed thyroid dysfunction in the first year post transplant, and 20.5% in the second year. Conclusion: The incidence of abnormal thyroid function for adult patients after HSCT is around 30%. Most of the abnormalities happened in the first 2 years after transplant. Female gender, allogenic transplant, and TBI-based conditioning were associated with more occurrences of thyroid function abnormalities.

journal of endocrinology and diabetes

Incidence and Predicting Factors for Abnormal Thyroid Function Test in Adult Patients Post Hematopoietic Stem Cell Transplantation at King Hussein Cancer Center