Endocrine Abstracts

Introduction: Hodgkin lymphoma (HL) survivors may develop a range of long-term complications that arise years after therapy. Among these, the endocrine dysfunctions are a major concern. Aim: To investigate the long-term endocrine effects of HL treatment.

Methods: Revision of the HL patients’ medical files who were followed at our Endocrine Late-effects Clinics.

Results: We studied 178 patients (86 (48.3%) were female), whose mean age at HL diagnosis was 18.07±10.79 (2–56) years. Chemotherapy was offered to 177(99.4%) patients and radiotherapy to 157 (88.2%). Hypothyroidism was identified in 76(42.7%) patients; women were not more affected than men (P=0.083). Mean time between radiotherapy and hypothyroidism diagnosis was 7.76±6.96 (1–39) years. Seven patients who developed hypothyroidism did not receive directed cervical radiotherapy and only 3 of them evidenced positive thyroid antibodies. Thyroid nodules were present in 41 (23%) patients. Mean time between radiotherapy and thyroid nodules development was 13.41±7.90 (1–35) years. Although women were more affected (P=0.01), they were not diagnosed earlier (P=0.842). Six (3.4%) patients developed thyroid cancer. Mean age at thyroid cancer diagnosis was 24.4±8.36 (17–34) years. Patients who developed thyroid cancer were significantly younger when they underwent radiotherapy (10.2±2.9 vs 20.3±9.8/P=0.024). Mean time between radiotherapy and thyroid cancer diagnosis was 16.25±5.5 (11–21) years. Ten (11.63%) women developed breast cancer, 16.7±6.03 (7–25) years after HL therapy. Hypogonadism was observed in 32 women and 12 men; mean age at hypogonadism diagnosis was 28.07±8.92 (13–48) and 40.5±17.19 (14–66) years, respectively. Women (P<0.001) and men (P=0.001) who developed hypogonadism were older when they received HL therapy. Median time between HL therapy and hypogonadism was significantly shorter in women (1(0–18) vs 11.5 (3–39) years; (P<0.001)). Women who recovered their gonadic function were younger when they received lymphoma therapy (17.5±7.0 vs 20.46±9.8/P=0.026).

Conclusion: Given the high relevance of endocrine dysfunctions in these patients, in order to early identify and manage them, a long-term endocrine follow-up is needed, with adequate protocols.