Endocrine late sequelae in long-term survivors of childhood non-Hodgkin lymphoma
Menée auprès de 84 survivants d'un lymphome non hodgkinien pédiatrique, cette étude de cohorte rétrospective analyse les effets à long terme sur le système endocrinien des traitements reçus pendant l'enfance
Background: Aim of this study was to investigate the long-term endocrine effects of treatment of childhood non-Hodgkin lymphoma (NHL).Patients and methods: A single-center cohort of 84 survivors (22 females) was included in this retrospective study. Median age was 21 years (9–40 years) and time after cessation of therapy 12 years (4–30 years). Height, weight, percentage fat, lean body mass (LBM), bone mineral content (BMC), bone mineral density of total body (BMDTB) and bone mineral density of lumbar spine (BMDLS) were measured. Thyroid-stimulating hormone (TSH), free thyroxin (fT4), insulin-like growth factor-1 (IGF-1), inhibin B and anti-müllerian hormone (AMH) levels were measured. Results were compared with Dutch controls.Results: Height was lower in survivors [mean standard deviation score (SDS) −0.36, P = 0.002], but further analysis showed that shorter stature was already present at diagnosis (mean SDS −0.28, P = 0.023). Body mass index, percentage fat, BMC, BMDTB and BMDLS were not different from controls. LBM was lower in survivors (mean SDS −0.47, P = 0.008). TSH, fT4 and IGF-1 were normal in all survivors. Three of 20 adult females had low AMH levels and 23 of 42 adult males had low inhibin B levels.Conclusions: Twelve years after cessation of treatment, NHL survivors did not develop adiposity, osteoporosis or thyroid disease. Male survivors may be at risk for infertility.