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Endocrine and metabolic disorders in young adult survivors of childhood acute lymphoblastic leukaemia (ALL) or non-Hodgkin lymphoma (NHL).
- Source :
-
Clinical endocrinology [Clin Endocrinol (Oxf)] 2008 Nov; Vol. 69 (5), pp. 819-27. Date of Electronic Publication: 2008 Apr 21. - Publication Year :
- 2008
-
Abstract
- Background: Treatments of acute lymphoblastic leukaemia (ALL) and non-Hodgkin lymphoma (NHL), involving various combinations of chemotherapy (chemo), cranial irradiation (CI) and/or bone marrow transplantation after total body irradiation (BMT/TBI), are often successful but may have several long-term harmful effects.<br />Objective: To evaluate late endocrine and metabolic complications in adult survivors of childhood ALL and NHL, in relation with the different therapeutic schemes received.<br />Design: Endocrine and metabolic parameters were determined in 94 patients (48 men, mean age: 24 +/- 5 years) with a former childhood ALL (n = 78) or NHL (n = 16) and subgrouped according to their previous treatment: chemo only (group I; n = 44), chemo + CI (group II; n = 32) and chemo + BMT/TBI (group III; n = 18).<br />Results: Severe GH deficiency (peak < 3.0 ng/ml after glucagon) was observed in 22% and 50% of patients of groups II and III, respectively, while hypothyroidism was mainly observed in group III (56%). Moreover, 83% of men developed hypogonadism after BMT/TBI, compared to 17% and 8% in groups I and II, respectively (P < 0.05), and all grafted women had ovarian failure, in contrast with other female patients in whom menarche had occurred spontaneously. Patients with BMT/TBI had also an adverse metabolic profile, with insulin resistance in 83% and dyslipidaemia in 61%.<br />Conclusions: This study reveals a high prevalence of endocrine and metabolic disorders in young adult survivors of childhood ALL or NHL, this frequency mainly depending on the treatment received. Treatment with BMT/TBI is the most detrimental and many of these patients will develop GHD, hypothyroidism, hypogonadism, insulin resistance and dyslipidaemia.
- Subjects :
- Adolescent
Adult
Age of Onset
Endocrine System Diseases complications
Endocrine System Diseases physiopathology
Female
Gonads physiology
Human Growth Hormone blood
Human Growth Hormone metabolism
Humans
Insulin-Like Growth Factor I metabolism
Lymphoma, Non-Hodgkin complications
Lymphoma, Non-Hodgkin physiopathology
Lymphoma, Non-Hodgkin rehabilitation
Male
Metabolic Diseases complications
Metabolic Diseases physiopathology
Precursor Cell Lymphoblastic Leukemia-Lymphoma complications
Precursor Cell Lymphoblastic Leukemia-Lymphoma physiopathology
Precursor Cell Lymphoblastic Leukemia-Lymphoma rehabilitation
Prevalence
Signal Transduction physiology
Thyroid Gland physiology
Young Adult
Endocrine System Diseases epidemiology
Lymphoma, Non-Hodgkin epidemiology
Metabolic Diseases epidemiology
Precursor Cell Lymphoblastic Leukemia-Lymphoma epidemiology
Survivors statistics & numerical data
Subjects
Details
- Language :
- English
- ISSN :
- 1365-2265
- Volume :
- 69
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Clinical endocrinology
- Publication Type :
- Academic Journal
- Accession number :
- 18429947
- Full Text :
- https://doi.org/10.1111/j.1365-2265.2008.03283.x