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Incidence of thyroid dysfunction in children after HSCT with reduced intensity conditioning (RIC) or myeloablative conditioning (MAC)
Author(s) -
Wang YunZu M.,
Howell Jonathan C.,
Grimley Michael S.,
Lane Adam,
Davies Stella M.,
Myers Kasiani C.
Publication year - 2021
Publication title -
pediatric transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.457
H-Index - 69
eISSN - 1399-3046
pISSN - 1397-3142
DOI - 10.1111/petr.13983
Subject(s) - medicine , regimen , asymptomatic , incidence (geometry) , total body irradiation , thyroid , cumulative incidence , hematopoietic stem cell transplantation , pediatrics , cohort , conditioning regimen , thyroid disease , transplantation , surgery , chemotherapy , cyclophosphamide , physics , optics
We have previously demonstrated a 11% incidence of post‐transplant de novo thyroid disease, even with a radiation‐free RIC regimen. Following the enactment of a universal late effects screening program at our institution, we compared the outcomes of 108 pediatric hematopoietic stem cell transplant recipients after a RIC regimen ( n = 33) to those after a MAC regimen ( n = 75) during the same time period. Overall, 10% of subjects developed thyroid dysfunction after HSCT, with a median follow‐up of 669 days. Seven subjects had primary hypothyroidism prior to HSCT. Of the thirty‐one subjects who received RIC, one (3.2%) developed a new thyroid disorder, compared to the nine of sixty‐nine (13.0%) subjects who received MAC ( p = .167). No significant associations were seen with donor type, graft‐vs.‐host disease, or total body irradiation. Nine of the 10 subjects who developed thyroid disease after transplant were asymptomatic. Continued follow‐up of this contemporary cohort will further delineate risk factors for post‐transplant‐associated thyroid dysfunction and better inform discussions of transplant‐associated sequelae.