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Thyroid dysfunction in adult hematopoietic cell transplant survivors: risks and outcomes

Bone Marrow Transplantation volume 53, pages 977–982 (2018)Cite this article

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Abstract

The incidence and risk factors for thyroid disorders among adult survivors of allogeneic hematopoietic stem cell transplantation (alloHCT) is not well known. This study evaluated incidence and risk factors of thyroid dysfunction in 259 adult alloHCT recipients who had survived for 2 years or more after transplant. Median follow-up was 4.6 years (range; 2.3 to 15.4 years). The 5-year cumulative incidence of thyroid dysfunction was 30.5% (79 of 259 patients). Majority of thyroid abnormalities were observed beyond 2 years after alloHCT. Subclinical hypothyroidism was the most common thyroid abnormalities accounting for 89% of cases (71 patients). Among these, treatment with thyroid replacement was eventually started in 44% (31 patients). Based on the multivariate analysis, thyroid abnormality was more likely in patients who received high-dose (≥12 Gy) total body irradiation (TBI)-based conditioning regimen compare to low-dose TBI-based (≤500 cGy) and non-TBI-conditioning regimen (p = 0.032). This risk was further augmented directly proportional with the time from alloHCT. These data identify high-dose TBI-conditioning regimen as a risk factor for thyroid dysfunction in adult recipients of alloHCT.

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This material is original research, has not been previously published and has not been submitted for publication elsewhere while under consideration.

Authors’ contributions

NF, MNS, and SKH conceived and initiated the project. NF wrote the first draft of the manuscript. All authors contributed substantially to the conception, acquisition, analysis, and interpretation of the data for the work and approved the final approval of the version to be published.

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Authors and Affiliations

  1. Division of Hematology & Oncology, University of Florida, 1600 SW Archer Rd, Gainesville,, 32610-0278, FL, USA

    Nosha Farhadfar

  2. Division of Endocrinology, Diabetes, Metabolism and Nutrition, Mayo Clinic, 200 1st Street SW, Rochester, MN, 55905, USA

    Marius N. Stan, Pankaj Shah & Vikram Sonawane

  3. Department of Medicine, Division of Hematology, Mayo Clinic, 200 1st Street SW, Rochester, MN, 55905, USA

    Mehrdad T. Hefazi

  4. Division of Hematology & Oncology, University of Florida, 1600 SW Archer Rd, Gainesville, FL, 32610-0278, USA

    Hemant S. Murthy

  5. Biostatistics, University of Florida, 2004 Mowry Road, Gainesville, FL, 32610-0278, USA

    Fay Zou & Xiong Sican

  6. Department of Medicine, Mayo Clinic, 200 1st Street SW, Rochester, MN, 55905, USA

    Shahrukh K. Hashmi

  7. King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia

    Shahrukh K. Hashmi

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  1. Nosha Farhadfar
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Correspondence to Shahrukh K. Hashmi.

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Farhadfar, N., Stan, M.N., Shah, P. et al. Thyroid dysfunction in adult hematopoietic cell transplant survivors: risks and outcomes. Bone Marrow Transplant 53, 977–982 (2018). https://doi.org/10.1038/s41409-018-0109-5

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