Late Endocrine Side Effects in Children with Acute Leukemia

Turk J Haematol. 2007 Mar 5;24(1):8-13.

Abstract

This study was carried out in 28 patients (10 female, 18 male) diagnosed with acute leukemia, and aimed to investigate the abnormalities of endocrine system. Twenty-five of 28 patients were acute lymphoblastic leukemia and 3 were acute non-lymphocytic leukemia. Sixteen children were treated using BFM-90 chemotherapy protocol, and the rest with various regimens. Two patients were exposed to 12-13 Gy of total body irradiation followed by bone marrow transplantation. All patients were in remission at least five years. One (3%) of 28 patients had short stature and 4 (14%) had obesity. Pubertal status was retarded in 2 (7%) patients. Glucose intolerance, secondary hypothyroidism and hypergonadotropic hypogonadism were detected in 2, 1 and 2 patients, respectively. TSH response to TRH test was exaggerated in 1 and blunted in 3 patients.

Bu çalışmaya akut lösemi tanısı almış ve en az 5 yıldır remisyonda olan 28 hasta (10 kız, 18 erkek) dahil edildi ve bu olgularda endokrin yan etkiler araştırıldı. Yirmibeş hasta akut lenfoblastik lösemi, 3 hasta akut non-lenfositik lösemi tanısı almıştı. Onaltı çocuğun tedavisinde BFM-90 tadavi protokolü kullanılırken diğerleri farklı tedavi rejimleri aldılar. İki hastaya 12-13 Gy total vücut ışınlaması sonrası kemik iliği transplantasyonu uygulandı. Yirmisekiz hastadan birinde (%3) boy kısalığı, dördünde (%14) obezite mevcuttu. Hastaların ikisinde (%7) gecikmiş puberte, ikisinde glukoz intoleransı, birinde sekonder hipotroidizm ve ikisinde de hipergonadotropik hipogonadizm saptandı. Bir olguda TRH testine abartılı TSH yanıtı, 3 olguda baskılanmış yanıt gözlendi.