Endocrine Abstracts

Stem cell transplants are used to treat and cure many types of haematological malignancies as well as rare solid-organ tumours. The conditioning regimes, medications and potential graft vs host disease can have effects on many organ systems in the body. The Endocrinology Department has designed a follow-up service over the past 3 years for patients in remission due to increasing awareness of the potential endocrinological and metabolic effects of allogenic stem cell transplant. This study aims to identify the effects allogenic stem cell transplant has on those systems. We retrospectively analysed patients who received bone marrow transplants in St. James Hospital between 2002 to 2018. We have analysed patients above 18 years old who have undergone stem cell transplant, attended the late effects clinic and are clinically in remission and deemed long term survivors. Metabolic and endocrinological markers such as liver function tests, glycated haemoglobin, fasting lipids, thyroid function tests, and reproductive hormones levels were obtained and measured over time. There were 412 late effects patients who had stem cell transplants between 2002 to 2018. We have analysed year one data from 100 patients who had bone marrow transplant between January 2016 to December 2019. Average age of these patients at time of bone marrow transplant are 43.6 (± 14.4) years old.2 patients had biochemical evidence of hypothyroidism. 17 had biochemical evidence of subclinical hypothyroidism. Average time of onset was 10.7 (± 4.3) months from receiving bone marrow transplant. Average thyroid stimulating hormone (TSH) at time of onset was 6.65 (± 4.33) mU/l with free T4 of 13.12 (± 4.32) pmol/l. 1 patient developed subclinical hyperthyroidism with TSH 0.04 mU/l and T4 of 21 pmol/l prior to developing hypothyroidism. There were 45 females analysed so far. 4 of those patients under 40 years old developing hypoestrogenism, all within 3 months of transplantation. 55 males were analysed with none having biochemical evidence of hypogonadism within that one year. 53 patients had deranged liver function tests with average time of onset of 7.4 (± 2.1) months. The long-term effects of bone marrow transplant on metabolic and endocrinological systems are still largely unknown. This study emphasizes the need for ongoing endocrinological support for these patients as well as further research into the long-lasting impact bone marrow transplants can have on these patients.