Supklinički hipotireoidizam posle transplantacije matičnih ćelija hematopoeze kod dece i adolescenata koji nisu dobijali radioterapiju

  • Tatjana Milenković Department of Endocrinology, Mother and Child Health Care Institute of Serbia “Dr Vukan Čupić”, Belgrade, Serbia
  • Dragana Vujić Pediatric HSCT Center, Mother and Child Health Care Institute of Serbia “Dr Vukan Čupić”, Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Belgrade, Serbia
  • Rade Vuković Department of Endocrinology, Mother and Child Health Care Institute of Serbia “Dr Vukan Čupić”, Belgrade, Serbia
  • Željko Zečević Pediatric HSCT Center, Mother and Child Health Care Institute of Serbia “Dr Vukan Čupić”, Belgrade, Serbia
  • Ivan Soldatović Institute of Medical Statistics, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
  • Katarina Mitrović Department of Endocrinology, Mother and Child Health Care Institute of Serbia “Dr Vukan Čupić”, Belgrade, Serbia
  • Sladjana Todorovic Department of Endocrinology, Mother and Child Health Care Institute of Serbia “Dr Vukan Čupić”, Belgrade, Serbia
  • Dragan Zdravković Department of Endocrinology, Mother and Child Health Care Institute of Serbia “Dr Vukan Čupić”, Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Belgrade, Serbia
DOI: https://doi.org/10.2298/4532
Ključne reči: hematopoietic stem cell transplantation||, ||transplantacija hematopoeznih matičnih ćelija, child||, ||deca, adolescent||, ||adolescenti, hypothyroidism||, ||hipotireoidizam, radiotherapy||, ||radioterapija,

Sažetak


Uvod/Cilj. Iako se smatra da je radioterapija posle transplantacije matičnih ćelija hematopoeze (TMĆH) glavni uzrok poremećaja tireoidne funkcije, u više istraživanja utvrđena je značajna prevalencija supkliničkog hipotireoidizma posle TMĆH kada u sklopu kondicioniranja nije korišćena radioterapija, već isključivo hemioterapija. Cilj ovog istraživanja bio je procena promene u nivoima tireostimulišućeg hormona (TSH) posle TMĆH kod dece koja nisu zračena tokom lečenja. Metode. Ispitivana grupa dece sastojala se od 41 deteta i adolescenta kojima je učinjena autologna ili alogena TMĆH i koji su praćeni najmanje godinu dana posle transplantacije. Radioterapija nije primenjivana kod ispitanika, ni tokom pretransplantacione terapije, niti tokom kondicioniranja. Prosečno vreme praćenja iznosilo je 2,9 godina. Indikacije za TMĆH bile su: hematološko maligno oboljenje (41,5%), solidni maligni tumori (34,1%) i druga oboljenja (24,4%). Tireoidna funkcija svih ispitanika procenjena je pre TMĆH i na kraju perioda praćenja. Rezultati. Tireoidna disfunkcija posle TMĆH utvrđena je kod 27 (65,8%) ispitanika. Najčešći poremećaj funkcije bio je supklinički hipotireoidizam, kod 23 (56,1%) ispitanika, primarni hipotireoidizam kod jednog (2,4%) bolesnika, dok su 3 (7,3%) ispitanika imala niske nivoe slobodnog tiroksina i normalne vrednosti TSH. Značajno (p < 0.01) veća tendencija povećanja koncentracija TSH uočena je kod bolesnika koji su dobijali hemioterapiju u sklopu lečenja osnovne bolesti pre TMĆH. Zaključak. Nalazi učinjenog ispitivanja ukazuju na neophodnost dugoročnog praćenja tireoidne funkcije posle transplantacije matičnih ćelja hematopoeze, bez obzira na primenu radioterapije.

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Objavljeno
2015/04/24
Broj časopisa
Vol. 71 Br. 12 (2014)
Rubrika
Originalni članak