Contributions
Abstract: PB2005
Type: Publication Only
Background
Childhood Hodgkin's lymphoma has been treated successfully for decades now. Long-term survivors of Hodgkin lymphoma (HL) are at an increased risk for a range of late complications. Raising awareness, close follow-up, and adoption of selected early-detection and risk-reduction strategies may help to reduce the adverse impact of these late effects on patients.
Aims
The aim of this study is the evaulation of long-term endocrinologic side effects on thyroid functions and bone mineral density due to childhood Hodgkin's lymphoma treatment.
Methods
This prospective study was held with 40 patients (34 male, 6 female), who had been treated between 1994-2013 in Pediatric Hematology and Oncology Department of Kanuni Sultan Suleyman Education and Research Hospital. Demographics, histopathological characteristics of tumor, stage, age at the time of radiotherapy, dose of radiations, time period after radiotherapy protocol, TSH, free T4, antithyroglobulin, anti-thyroid peroxidase, calcitonin, thyroglobulin, thyroid ultrasonography, any thyroid nodules, levels of calcium, phosphate, magnesium, ALP, 25OH-vitamine D, PTH and z-scores were all recorded for each patient on a study form. Whenever a nodule was detected in thyroid ultrasonography, sintigraphy was carried out followed by a biopsy, if indicated.
Results
The ages of patients were ranging between 4-31 years (mean 14.13 ± 6.08). All patients were treated with chemotherapy combined with radiotherapy. Average dose of radiotherapy was 21.487± 4.487 Gy. In 72.5% of patients the primary disease was localised on head and neck. Seven patients had B symptoms. Eleveted TSH levels were detected in twelve of forty patients (30%). Thyroid hormon therapy was given to five patients, who have clinical symptoms of hypothyroidism. Nodule in thyroid gland was detected in five patients by ultrasonography. Three patients were directed to biopsy according to scintigraphic and ultrasonographic evaluations. Hypothyroidism was detected 3.10 ± 2.02 years and nodules were detected 8.90 ± 7.90 years after treatment
Five (12.5%) out of 40 patients had osteoporosis detected by dual-energy X-ray absorbsiometry. Mean age of patients with osteoporosis was 16.4 ± 6.88 while mean age of patients was 13.8 ± 6. In 25 patients 25-OH D vitamin levelswere below normal. Among 7 patients having B symptoms 3 (42.8%), 11 patients under combined chemotherapy with steroid 3 (27.5%) had osteoporosis.
Conclusion
Patients with Hodgkin lymphoma under treatment may have abnormal thyroid functions and osteoprorsis as long term complications. Their evaluation for thyroid functions and osteoporosis are needed. Timely replacement therapies diminish the appearance of these complications and improve the quality of life of the patients.
Session topic: 17. Hodgkin lymphoma – Clinical
Keyword(s): Bone mineral density, Complications, Hodgkin's Lymphoma
Abstract: PB2005
Type: Publication Only
Background
Childhood Hodgkin's lymphoma has been treated successfully for decades now. Long-term survivors of Hodgkin lymphoma (HL) are at an increased risk for a range of late complications. Raising awareness, close follow-up, and adoption of selected early-detection and risk-reduction strategies may help to reduce the adverse impact of these late effects on patients.
Aims
The aim of this study is the evaulation of long-term endocrinologic side effects on thyroid functions and bone mineral density due to childhood Hodgkin's lymphoma treatment.
Methods
This prospective study was held with 40 patients (34 male, 6 female), who had been treated between 1994-2013 in Pediatric Hematology and Oncology Department of Kanuni Sultan Suleyman Education and Research Hospital. Demographics, histopathological characteristics of tumor, stage, age at the time of radiotherapy, dose of radiations, time period after radiotherapy protocol, TSH, free T4, antithyroglobulin, anti-thyroid peroxidase, calcitonin, thyroglobulin, thyroid ultrasonography, any thyroid nodules, levels of calcium, phosphate, magnesium, ALP, 25OH-vitamine D, PTH and z-scores were all recorded for each patient on a study form. Whenever a nodule was detected in thyroid ultrasonography, sintigraphy was carried out followed by a biopsy, if indicated.
Results
The ages of patients were ranging between 4-31 years (mean 14.13 ± 6.08). All patients were treated with chemotherapy combined with radiotherapy. Average dose of radiotherapy was 21.487± 4.487 Gy. In 72.5% of patients the primary disease was localised on head and neck. Seven patients had B symptoms. Eleveted TSH levels were detected in twelve of forty patients (30%). Thyroid hormon therapy was given to five patients, who have clinical symptoms of hypothyroidism. Nodule in thyroid gland was detected in five patients by ultrasonography. Three patients were directed to biopsy according to scintigraphic and ultrasonographic evaluations. Hypothyroidism was detected 3.10 ± 2.02 years and nodules were detected 8.90 ± 7.90 years after treatment
Five (12.5%) out of 40 patients had osteoporosis detected by dual-energy X-ray absorbsiometry. Mean age of patients with osteoporosis was 16.4 ± 6.88 while mean age of patients was 13.8 ± 6. In 25 patients 25-OH D vitamin levelswere below normal. Among 7 patients having B symptoms 3 (42.8%), 11 patients under combined chemotherapy with steroid 3 (27.5%) had osteoporosis.
Conclusion
Patients with Hodgkin lymphoma under treatment may have abnormal thyroid functions and osteoprorsis as long term complications. Their evaluation for thyroid functions and osteoporosis are needed. Timely replacement therapies diminish the appearance of these complications and improve the quality of life of the patients.
Session topic: 17. Hodgkin lymphoma – Clinical
Keyword(s): Bone mineral density, Complications, Hodgkin's Lymphoma