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Thyroid dysfunction after bone marrow transplantation for primary immunodeficiency without the use of total body irradiation in conditioning

Lookup NU author(s): Dr Mary Slatter, Professor Andrew GenneryORCiD, Professor Timothy Cheetham, Dr Terence Flood, Professor Andrew Cant, Dr Mario Abinun

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Abstract

Thyroid dysfunction, a common long-term complication following bone marrow transplantation (BMT), is frequently associated with total body irradiation (TBI) given in the pre-BMT conditioning protocol. We report our preliminary observation of the prevalence of thyroid dysfunction in children transplanted for primary immunodeficiency (PID) who were given cytoreductive conditioning with busulphan and cyclophosphamide, but without TBI. We evaluated thyroid-stimulating hormone (TSH) and free thyroxine (fT4) in 83 survivors transplanted between 1987 and 2002. We found nine children (10.8%) with clinical and/or biochemical thyroid dysfunction at 4 months to 4.5 years post-BMT of which three had positive antithyroid microsomal antibodies. Two patients were classified as primary and seven as compensated hypothyroidism (hyperthyrotropinaemia). Four patients with clinical features of hypothyroidism received replacement thyroxine, while five of the seven patients with compensated hypothyroidism remain off thyroxine because we suspect this may be a transient phenomenon. Abnormalities of thyroid function including severe primary hypothyroidism may occur post-BMT in children receiving chemotherapy conditioning without TBI. Thyroid function should be assessed regularly in this group of patients. © 2004 Nature Publishing Group. All rights reserved.


Publication metadata

Author(s): Slatter MA, Gennery AR, Cheetham TD, Bhattacharya TD, Crooks BNA, Flood TJ, Cant AJ, Abinun M

Publication type: Article

Publication status: Published

Journal: Bone Marrow Transplantation

Year: 2004

Volume: 33

Issue: 9

Pages: 949-953

ISSN (print): 0268-3369

ISSN (electronic): 1476-5365

Publisher: Nature Publishing Group

URL: http://dx.doi.org/10.1038/sj.bmt.1704456

DOI: 10.1038/sj.bmt.1704456

PubMed id: 15004542


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