Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Post-Transplant Events

Late thyroid toxicity in 153 long-term survivors of allogeneic bone marrow transplantation for acute lymphoblastic leukaemia

Bone Marrow Transplantation volume 35, pages 991–995 (2005)Cite this article

Summary:

The purpose of this study was to identify risk factors for hypothyroidism after bone marrow transplantation (BMT) for high-risk or relapsed acute lymphoblastic leukaemia (ALL) in children. In all, 388 children with acute lymphoblastic leukaemia underwent allogeneic bone marrow transplantation between 1984 and 1994. Overall 5-year survival was 54.6%. Thyroid function was assessed in the 153 patients with more than 5 years of follow-up. In total, 16 patients developed uncompensated hypothyroidism (UH) and 46 compensated hypothyroidism (CH) a median of 2.9 and 2.7 years, respectively, after BMT. Thyroid dysfunction-free survival rates were 73.2% after 5 years and 59.2% after 10 years. Three factors were significantly associated with the onset of hypothyroidism, namely age, bone marrow transplantation in second remission, and single-dose total body irradiation (TBI). Ultrasonography of the thyroid showed nodules in 10 of 35 patients. The median time from BMT to nodule detection was 7.8 years. Cytology (n=5) and surgery (n=4) showed no evidence of thyroid cancer. Four of the 14 patients who received cytoreduction without TBI but with busulphan and cyclophosphamide developed UH (n=2) or CH (n=2). We concluded that children who undergo BMT for ALL are at a high risk of subsequent thyroid dysfunction.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1

Similar content being viewed by others

References

  1. Collet D . Modelling Survival Data in Medical Research. Chapman & Hall: London, 1994.

    Book  Google Scholar 

  2. Schemper M, Stare J . Explained variation in survival analysis. Stat Med 1996; 19: 1999–2012.

    Article  Google Scholar 

  3. Pasqualini T, McCalla J, Berg S et al. Subtle primary hypothyroidism in patients treated for acute lymphoblastic leukaemia. Acta Endocrinol (Copenh) 1991; 124: 375–380.

    Article  CAS  Google Scholar 

  4. Boulad F, Bromley M, Black P et al. Thyroid dysfunction following bone marrow transplantation using hyperfractionated radiation. Bone Marrow Transplant 1995; 15: 71–76.

    CAS  PubMed  Google Scholar 

  5. Borgström B, Bolme P . Thyroid function in children after allogenic bone marrow transplantation. Bone Marrow Transplant 1994; 13: 59–64.

    PubMed  Google Scholar 

  6. Thomas BC, Stanhope R, Plowman PN et al. Endocrine function following single fraction and fractionated total body irradiation for bone marrow transplantation in childhood. Acta Endocrinol 1993; 128: 508–512.

    Article  CAS  Google Scholar 

  7. Sanders JE, and the long term follow-up team. Endocrine problems in children after bone marrow transplant for hematologic malignancies. Bone Marrow Transplant 1991; 8: 2–4.

    PubMed  Google Scholar 

  8. Michel G, Socié G, Gebhard F et al. Late effects of allogenic bone marrow transplantation for children with acute myeloblastic leukaemia in first complete remission: the impact of conditioning regimen without total body irradiation, a report from the Société Française de Greffe de Moelle. J Clin Oncol 1997; 15: 335–340.

    Article  Google Scholar 

  9. Katsanis E, Shapiro RS, Robinson LL et al. Thyroid dysfunction following bone marrow transplantation: long term follow-up of 80 pediatric patients. Bone Marrow Transplant 1990; 5: 335–340.

    CAS  PubMed  Google Scholar 

  10. Toubert ME, Socié G, Gluckman E et al. Short and long-term follow-up of thyroid dysfunction after allogeneic bone marrow transplantation without the use of preparative total body irradiation. Br J Haematol 1997; 98: 453–457.

    Article  CAS  PubMed  Google Scholar 

  11. Thuret I, Michel G, Carla H et al. Long term side-effects in children receiving allogeneic bone marrow transplantation in first complete remission of acute leukaemia. Bone Marrow Transplant 1995; 15: 337–341.

    CAS  PubMed  Google Scholar 

  12. Cohen A, Rovelli A, Van Lint MT et al. Secondary thyroid carcinoma after allogeneic bone marrow transplantation during childhood. Bone Marrow Transplant 2001; 28: 1125–1128.

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgements

This work was supported by grants from CHIRON, AMGEN and Ligue Contre le Cancer de la Loire. We thank all the clinicians who gave us access to their patients' data, namely E Gluckman (Hôpital St Louis, Paris), G Souillet (Hôpital Debrousse, Lyon), JH Bourhis (Institut Gustave Roussy, Villejuif), JP Jouet (CHU, Lille), F Bernaudin (Hôpital Henri Mondor, Creteil) F Mechinaud (Hôtel Dieu, Nantes), A Fischer (Hôpital Necker, Paris) F Demeocq (Hôtel Dieu, Clermont-Ferrand), H Rubie (Hôpital Purpan, Toulouse), D Blaise (Institut Calmette, Marseille), JP Vannier (Hôpital d'enfants, Rouen), P Lutz (CHU, Strasbourg), D Plantaz (CHU, Grenoble), P Boutard (CHU, Caen), G Leverger (Hôpital Trousseau, Paris), V Gandemer (CHU, Rennes), and B Deygas for her technical assistance. We thank David Young for editing this paper.

Author information

Authors and Affiliations

  1. Service de Pédiatrie, CHRU Hôpital Nord, Saint-Étienne Cedex, France

    C Berger, B Le-Gallo, O Richard & J L Stephan

  2. Hôpital Trousseau, Paris, France

    J Donadieu

  3. Hôpital St Louis Paris, France

    A Devergie

  4. Hôpital Debrousse, Lyon, France

    C Galambrun

  5. Hôpital Brabois, Nancy, France

    P Bordigoni

  6. Hôpital Robert Debré, Paris, France

    E Vilmer

  7. Hôpital St Jacques, Besançon, France

    E Plouvier

  8. CHU, Bordeaux, France

    Y Perel

  9. Hôpital Nord, Marseille, France

    G Michel

Authors
  1. C Berger
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. B Le-Gallo
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. J Donadieu
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. O Richard
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. A Devergie
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. C Galambrun
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. P Bordigoni
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. E Vilmer
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. E Plouvier
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Y Perel
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. G Michel
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. J L Stephan
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to C Berger.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Berger, C., Le-Gallo, B., Donadieu, J. et al. Late thyroid toxicity in 153 long-term survivors of allogeneic bone marrow transplantation for acute lymphoblastic leukaemia. Bone Marrow Transplant 35, 991–995 (2005). https://doi.org/10.1038/sj.bmt.1704945

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.bmt.1704945

Keywords

This article is cited by

Search

Advanced search

Quick links