Changes in thyroid function parameters 3 months after allogeneic and autologous hematopoietic stem cell transplantation in children

Eur J Endocrinol. 2023 Jun 7;188(6):503-509. doi: 10.1093/ejendo/lvad058.

Abstract

Background: Thyroid dysfunction (hypo- and hyperthyroidism) has been reported as a late effect after hematopoietic stem cell transplantation (HSCT) in children. Short-term effects of HSCT on thyroid function parameters are, however, unclear.

Methods: We prospectively evaluated thyroid function parameters before and 3 months after HSCT in all children (<21 years) who underwent HSCT during a 2-year period in the Princess Máxima Center, the Netherlands.

Results: Among 72 children, none had thyroidal hypothyroidism or hyperthyroidism 3 months after HSCT. Changes in thyroid function parameters (either aberrant thyroid-stimulating hormone [TSH] or free thyroxine [FT4] concentrations) were found in 16% before and in 10% 3 months after HSCT. Reverse triiodothyronine (rT3) was found elevated in 9.3% before and in 37% 3 months after HSCT, which could be related to poor physical condition. An individual decline in FT4 concentration of ≥20% was found in 10.5% (6/57) 3 months after HSCT.

Conclusion: In conclusion, thyroidal hypo- and hyperthyroidism are very rare 3 months after HSCT. These results indicate that surveillance for hypo- and hyperthyroidism may start later in time. The changes in thyroid function parameters found 3 months after HSCT might reflect euthyroid sick syndrome.

Keywords: hematopoietic stem cell transplantation; pediatrics; thyroid dysfunction.

MeSH terms

  • Child
  • Hematopoietic Stem Cell Transplantation* / adverse effects
  • Hematopoietic Stem Cell Transplantation* / methods
  • Humans
  • Hyperthyroidism* / epidemiology
  • Hypothyroidism* / epidemiology
  • Hypothyroidism* / etiology
  • Thyroid Diseases* / epidemiology