Abstract
34 children 1-17 years at the time of bone marrow transplantation (BMT) have been followed regarding their endocrinological development at yearly intervals for at least 3 years. Diagnosis leading to BMT was leukemia (n=28) or severe aplastic anemia (SAA n=6). Before BMT all the patients were conditioned with cyclophosphamide and the leukemic children also had total body irradiation (TBI) 10 GY. Challenge tests with TRH, ACTH and LH-RH were given and Cortisol response to insuline hypoglycemia was also evaluated. The children dith SAA all exhibited normal function of their thyroid, adrenal and gonadal glands. The leucemic children showed some sign of thyroid dysfunction in 14/28 cases. All leucemic girls (n=12) show evident signs of gonadal damage. None of them have entered into spontaneous puberty and have extremely low values of oestradiol at ages when puberty should have started. Gonadotropin levels were extremely high. The boys show more variation in their gonadal effects. Boys, prepubertal at BMT, have entered spontaneous puberty in due time in 4/5 cases although with decreased testicular volume. The boys who had entered puberty at the time of BMT have retained normal testosteron values but their testicles have decreased in size. The adrenal cortex seemed to be intact after BMT, evident by normal responses of cortisol, DHA and 17-OH-progesteron after ACTH. In conclusion, TBI seems to cause endocrine changes in cildren undergoing BMT for leucemia. The gonads especially in girls and the thyroid gland are affected while the adrenal cortex seems to stay normal
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Bolme, P., Borgström, B., Carlström, K. et al. 57 ENDOCRINE CHANGES IN CHILDREN AFTER ALLOGENEIC BONE MARROW TRANSPLANTATION. Pediatr Res 24, 526 (1988). https://doi.org/10.1203/00006450-198810000-00078
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DOI: https://doi.org/10.1203/00006450-198810000-00078