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Endocrinologic Late Effects of Chemoradiotherapy in Pediatric Acute Leukemia [Turk J Hematol]
Turk J Hematol. 2002; 19(2): 293-301

Endocrinologic Late Effects of Chemoradiotherapy in Pediatric Acute Leukemia

Sevgi Gözdaşoğlu1, Serap Aksoylar1, Merih Berberoğlu1, Gönül Öcal1, Pelin Adıyaman1, Ayhan O. Çavdar2, Emel Babacan1, Emel Ünal1, Nurdan Taçyıldız1, Gülsan Yavuz1
1Divisions Of Pediatric Hematology, Endocrinology And Oncology, Department Of Pediat Rics, School Of Medicine, University Of Ankara, Ankara, Turkey
2Honorary Chairman Of Turkish Academy Of Science, Ankara, Turkey

This study intends to describe growth and endocrine disorders secondary to chemotherapy among long-term survivors of pediatric acute leukemia. Sixteen patients including 14 ALL and 2 AML entered the study. Four were females and 12 were males with the mean age of 17.38 ± 3.81 years. Following the completion of their therapy, the mean follow up period of the patients was 62.43 ± 41.11 months. Somatic growth, sexual maturation, hypothalamic- pituitary-thyroid axis and hypothalamic-pituitary-gonadal axis were evaluated in all the patients. Two out of 16 had pathologic short stature (12.5%) and 3 patients had enuchoid status (18.75%) with antrophometric measurements. Eleven patients had normal thyroid gland dimensions and homogeneous thyroid tissue on ultrasonographic examination. One patient had Ia and another four patients had Ib diffuse goitre according to WHO criteria. Two out of 16 patients were diagnosed as subclinic primary hypothyroidism (12.5%), and three of them were diagnosed as subclinic central hypothyroidism (18.75%) according to TRH testing. Three patients were subclinic subtle central hypothyroidism. Thyroid auto-antibodies were in normal range in all patients. Eight patients (66.6%) out of 12 male subjects revealed impaired HHG axis. Hypergonadotropic hypogonadism (Leydig and Sertoli dysfunction) were observed in five of them and isolated Sertoli dysfunction was detected in three of them. Azoospermia was encountered in all patients with isolated Sertoli dysfunction. Testicular biopsy was obtained from only one of them and atrophic testicular tissue was detected. Female patients show normal pubertal development and gonadal functions. CONCLUSION: Subclinic subtle primary and subclinic central hypothyroidism were found in 31.2%, impaired Sertoli and Leydig with Sertoli cell function in 66.66% of long-term survivors pediatric acute leukemia and testicular tissue was more sensitive to adverse effects of chemotherapy than ovarian tissue.

Keywords: Chemoradiotherapy, Acute leukemia, Late effects, Endocrine.

Sevgi Gözdaşoğlu, Serap Aksoylar, Merih Berberoğlu, Gönül Öcal, Pelin Adıyaman, Ayhan O. Çavdar, Emel Babacan, Emel Ünal, Nurdan Taçyıldız, Gülsan Yavuz. Endocrinologic Late Effects of Chemoradiotherapy in Pediatric Acute Leukemia. Turk J Hematol. 2002; 19(2): 293-301

Corresponding Author: Sevgi Gözda&254;o&240;lu, Türkiye

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