ECEESPE2025 Poster Presentations Endocrine Related Cancer (76 abstracts)
Thyroid and pituitary dysfunction after total body irradiation as conditioning therapy of haematopoietic stem cell transplantation during childhood
Margarida Oliveira 1 , Sofia Avelino 2 , Ana Figueiredo 3 , Sofia F. Silva 2 , Carlos Marques 2 , Leonor Pinto 2 , Catarina Regala 2 , Sara Donato 2 , Daniela Cavaco 2 , Sara Pinheiro 2 & Joana Simões Pereira 2
1Unidade Local de Saúde de Lisboa Ocidental, Endocrinology department, Lisboa, Portugal; 2Instituto Português de Oncologia de Lisboa Francisco Gentil, Endocrinology department, Lisboa, Portugal; 3Hospital do Divino Espírito Santo, Ponta Delgada, Portugal
JOINT2766
Introduction: The endocrine system is commonly affected by chemotherapy and irradiation prior to allogeneic haematopoietic stem cell transplantation (HSCT) during childhood. Our aim was to analyse the incidence of thyroid and pituitary dysfunctions in paediatric survivors of HSCT, following total body irradiation (TBI) as conditioning therapy.
Objective: We analysed thyroid and pituitary dysfunctions in a cohort of paediatric patients who underwent TBI prior to HSCT.
Material and methods: This retrospective study included paediatric patients who underwent HSCT and received TBI, with a minimum follow-up of 24 months, followed-up at our endocrine late-effects clinic. We excluded patients who received cervical radiotherapy from the thyroid analysis and those who received central nervous system radiotherapy from the pituitary analysis. Statistical analysis was performed with IBM SPSS.
Results: We analysed data from 161 paediatric survivors who underwent HSCT and included 31 patients who received TBI as part of their conditioning therapy. The mean age of HSCT was 11. 0±5. 0 years and 51. 6%(n = 16) patients were male. The most prevalent haematological disease was acute lymphoblastic leukaemia (ALL), accounting for 48. 4% (n = 15) of cases. The median dose of TBI therapy was 10. 8 Gy (IQR 5. 7). The incidence of thyroid dysfunction in this cohort was 61. 3% (n = 19). The mean follow-up time was 21 ± 7 years. During follow-up, 12 (38. 7%) patients developed hypothyroidism, with a median time to diagnosis of 14 years (IQR 22) after TBI. Thyroid antibodies were negative in all patients tested (n = 31). Thyroid nodules were diagnosed in 21 (67. 7%) patients, with an average time after TBI of 16 years (IQR 7). The cumulative incidence of thyroid nodules increased over time, being 16%, 35%, and 52% after 10, 15, and 20 years, respectively. Papillary thyroid carcinoma was diagnosed in 7 (22, 6%) patients, with a median age at diagnosis of 26. 5 years (IQR 7). The median time to malignancy diagnosis was 21 years (IQR 13) post-TBI. One patient presented with both papillary and follicular carcinoma. We didn’t observe any pituitary dysfunction following TBI, including any puberty disorders.
Conclusion: These findings underlight the importance of long-term thyroid monitoring in paediatric HSCT survivors submitted to TBI. The majority of these patients were diagnosed with thyroid nodules, and its incidence increased throughout their follow-up. The low dose of radiation may explain the absence of pituitary disorders in these patients.
Volume 110
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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