Endocrine Abstracts

Aim: Endocrine and metabolic disorders are among the most common complications in survivors after hematopoietic stem cell transplant (HSCT). The aim of this study was to evaluate thyroid function and glucose metabolism in patients treated with HSCT.

Material and methods: This was a retrospective study which included 257 adult patients (173 males and 84 females) who underwent allogeneic HSCT between 2002 and 2014 in an Irish University Hospital. All patients were preconditioned with chemotherapy and total body irradiation (TBI). 121 patients received HSCT from unrelated donor, with 52.9% receiving HCST from related donors. Thyroid function was assessed early post HSCT (0–3 months), in the intermediate period (3–12 months) and late post HSCT (>12 months) with screening for diabetes at a median of 10 months (S.D. 18.21)

Results: The median age at diagnosis was 33 years (SD 10.45), with a median age at treatment of 35.3 years old (S.D. 10.27). The most common indication for HSCT was acute lymphoblastic leukaemia (39.68%) and the most used preconditioning regime was TBI/Cyclophosphamide (90.27%). 25 patients had thyroid function assessment in the early period of whom 32% had thyroid dysfunction. In the intermediate period, 86 patients were assessed, 19.76% of whom had thyroid abnormalities. In the late period, 172 patients had thyroid function assessment with 38.95% having an abnormal test. The 2 most frequent abnormalities were subclinical hypothyroidism, and a low FT4 with an inappropriately low or normal TSH. 45 patients had HbA1c testing, with 48.88% being diagnosed with diabetes (HbA1c>6.5%) and 11.11% with pre-diabetes.

Conclusion: Our study provides evidence that the incidence of thyroid dysfunction and glucose metabolism abnormalities is higher post HSCT than in the general population. This emphasizes the need for long term screening for thyroid dysfunction and diabetes in the post HSCT population.