Endocrinopathies after Allogeneic and Autologous Transplantation of Hematopoietic Stem Cells
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- Francesco Orio
- Department of Sports Science and Wellness, University “Parthenope” Naples, 80133 Naples, Italy
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- Giovanna Muscogiuri
- Department of Clinical Medicine and Surgery, University Federico II Naples, 80131 Naples, Italy
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- Stefano Palomba
- Unit of Obstetrics and Gynaecology, “Arcispedale Santa Maria Nuova”, IRCCS, 42123 Reggio Emilia, Italy
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- Bianca Serio
- Hematology and Hematopoietic Stem Cell Transplant Center, Department of Medicine and Surgery, University of Salerno, 84131 Salerno, Italy
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- Mariarosaria Sessa
- Hematology and Hematopoietic Stem Cell Transplant Center, Department of Medicine and Surgery, University of Salerno, 84131 Salerno, Italy
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- Valentina Giudice
- Hematology and Hematopoietic Stem Cell Transplant Center, Department of Medicine and Surgery, University of Salerno, 84131 Salerno, Italy
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- Idalucia Ferrara
- Hematology and Hematopoietic Stem Cell Transplant Center, Department of Medicine and Surgery, University of Salerno, 84131 Salerno, Italy
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- Libuse Tauchmanovà
- Hematology and Hematopoietic Stem Cell Transplant Center, Department of Medicine and Surgery, University of Salerno, 84131 Salerno, Italy
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- Annamaria Colao
- Department of Clinical Medicine and Surgery, University Federico II Naples, 80131 Naples, Italy
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- Carmine Selleri
- Hematology and Hematopoietic Stem Cell Transplant Center, Department of Medicine and Surgery, University of Salerno, 84131 Salerno, Italy
抄録
<jats:p>Early and late endocrine disorders are among the most common complications in survivors after hematopoietic allogeneic- (allo-) and autologous- (auto-) stem cell transplant (HSCT). This review summarizes main endocrine disorders reported in literature and observed in our center as consequence of auto- and allo-HSCT and outlines current options for their management. Gonadal impairment has been found early in approximately two-thirds of auto- and allo-HSCT patients: 90–99% of women and 60–90% of men. Dysfunctions of the hypothalamus-pituitary-growth hormone/insulin growth factor-I axis, hypothalamus-pituitary-thyroid axis, and hypothalamus-pituitary-adrenal axis were documented as later complicances, occurring in about 10, 30, and 40–50% of transplanted patients, respectively. Moreover, overt or subclinical thyroid complications (including persistent low-T3 syndrome, chronic thyroiditis, subclinical hypo- or hyperthyroidism, and thyroid carcinoma), gonadal failure, and adrenal insufficiency may persist many years after HSCT. Our analysis further provides evidence that main recognized risk factors for endocrine complications after HSCT are the underlying disease, previous pretransplant therapies, the age at HSCT, gender, total body irradiation, posttransplant derangement of immune system, and in the allogeneic setting, the presence of graft-versus-host disease requiring prolonged steroid treatment. Early identification of endocrine complications can greatly improve the quality of life of long-term survivors after HSCT.</jats:p>
収録刊行物
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- The Scientific World Journal
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The Scientific World Journal 2014 1-13, 2014
Hindawi Limited