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Endocrine Complications in Childhood Cancer Survivors

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Blood and Marrow Transplant Handbook

Abstract

Endocrine complications are among the commonly observed complications in childhood cancer survivors, affecting between 20 and 50 % of individuals who survive into adulthood. Most endocrine complications are the result of prior cancer treatments, especially radiotherapy, and often manifesting several years, sometimes decades after exposure. Such treatments can cause direct damage to the hypothalamic–pituitary axis, thyroid gland, and gonads, induce osteopenia and osteoporosis, and alter body composition and glucose homeostasis. The integrity of endocrine function is important for the maintenance of an individual’s physical and psychosocial well-being. Given the high rates of frailty and decreased quality of life in childhood cancer survivors, long-term endocrine screening, treatment, and follow-up need to become a priority for clinicians and investigators with expertise in this field. The aim of the present review is to highlight the main endocrine complications, including disorders of the hypothalamic–pituitary axis, thyroid dysfunction, gonadal dysfunction, decreased bone mineral density, obesity, and disorders in glucose homeostasis, and to provide recommendations for screening for late endocrine complications observed in this vulnerable population.

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References

  • Aisenberg J, Hsieh K, et al. Bone mineral density (BMD) in long-term survivors of childhood cancer. J Pediatr Hematol Oncol. 1998;20:241–5.

    Article  CAS  PubMed  Google Scholar 

  • Armstrong GT, Whitton JA, Gajjar A, et al. Abnormal timing of menarche in survivors of central nervous system tumors. A report from the Childhood Cancer Survivor Study. Cancer. 2009;115:2562–70.

    Article  PubMed Central  PubMed  Google Scholar 

  • Au WY, Lie AK, Kung AW, et al. Autoimmune thyroid dysfunction after hematopoietic stem cell transplantation. Bone Marrow Transplant. 2005;35:383–8.

    Article  CAS  PubMed  Google Scholar 

  • Barton SE, Najita JS, Ginsburg ES, et al. Infertility, infertility treatment, and achievement of pregnancy of female survivors of childhood cancer: a report from the Childhood Cancer Survivor Study cohort. Lancet Oncol. 2013;14:873–81.

    Article  PubMed  Google Scholar 

  • Byrne J, Fears TR, Mills JL, et al. Fertility of long-term male survivors of acute lymphoblastic leukemia diagnosed during childhood. Pediatr Blood Cancer. 2004;42:364–72.

    Article  PubMed  Google Scholar 

  • Chemaitilly W, Sklar CA. Endocrine complications in long-term survivors of childhood cancers. Endocr Relat Cancer. 2010;17:R141–59.

    Article  CAS  PubMed  Google Scholar 

  • Chemaitilly W, Mertens AC, Mitby P, et al. Acute ovarian failure in the childhood cancer survivor study. J Clin Endocrinol Metab. 2006;91:1723–8.

    Article  CAS  PubMed  Google Scholar 

  • Chemaitilly W, Boulad F, Oeffinger KC, et al. Disorders of glucose homeostasis in young adults treated with total body irradiation during childhood: a pilot study. Bone Marrow Transplant. 2009;44:339–43.

    Article  CAS  PubMed  Google Scholar 

  • Chow EJ, Friedman DL, Yasui Y, et al. Timing of menarche among survivors of childhood acute lymphoblastic leukemia: a report from the Childhood Cancer Survivor Study. Pediatr Blood Cancer. 2008;50:854–8.

    Article  PubMed  Google Scholar 

  • Chow EJ, Friedman DL, Stovall M, et al. Risk of thyroid dysfunction and subsequent thyroid cancer among survivors of acute lymphoblastic leukemia: a report from the childhood cancer survivors study. Pediatr Blood Cancer. 2009;53:432–7.

    Article  PubMed Central  PubMed  Google Scholar 

  • Clayton PE, Shalet SM. The evolution of spinal growth after irradiation. Clin Oncol. 1991;3:220–2.

    Article  CAS  Google Scholar 

  • Diller L, Chow EJ, Gurney GJ, et al. Chronic disease in the Childhood Cancer Survivor Study Cohort: a review of published findings. J Clin Oncol. 2009;27:2339–55.

    Article  PubMed Central  PubMed  Google Scholar 

  • Ergun-Longmire B, Mertens AC, Mitby P, et al. Growth hormone treatment and risk of second neoplasms in the childhood cancer survivor. J Clin Endocrinol Metab. 2006;91:3494–8.

    Article  CAS  PubMed  Google Scholar 

  • Gleeson HK, Stoeter R, Ogilvy-Stuart AL, et al. Improvements in final height over 25 years in growth hormone (GH)-deficient childhood survivors of brain tumors receiving GH replacement. J Clin Endocrinol Metab. 2003;88:3682–9.

    Article  CAS  PubMed  Google Scholar 

  • Green DM, Kawashima T, Stovall M, et al. Fertility of female survivors of childhood cancer: a report from the Childhood Cancer Survivor Study. J Clin Oncol. 2009;27:2677–85.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  • Hudson MM, Ness KK, Gurney JG, et al. Clinical ascertainment of health outcomes among adults treated for childhood cancer. JAMA. 2013;309:2371–81.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  • Jones TS, Kaste SC, Liu W, et al. CRHR1 polymorphisms predict bone density in survivors of acute lymphoblastic leukemia. J Clin Oncol. 2008;26:3031–7.

    Article  CAS  PubMed  Google Scholar 

  • Laughton SJ, Merchant TE, Sklar CA, et al. Endocrine outcomes for children with embryonalbrain tumors after risk adapted craniospinal and conformal primary-site irradiation and high-dose chemotherapy with stem cell rescue on the SJMB-96 trial. J Clin Oncol. 2008;27:1112–8.

    Article  Google Scholar 

  • Lewis K, Lee PA. Endocrinology of male puberty. Curr Opin Endocrinol Diabetes Obes. 2009;16:5–9.

    Article  CAS  PubMed  Google Scholar 

  • Linabery AM, Ross JA. Childhood and adolescent cancer survival in the US by race andethnicity for the diagnostic period 1975–1999. Cancer. 2008;113:2575–96.

    Article  PubMed Central  PubMed  Google Scholar 

  • Meacham LR, Sklar CA, Li S, et al. Diabetes mellitus in long-term survivors of childhood cancer. Increased risk associated with radiation therapy: a report from the Childhood Cancer Survivor Study. Arch Int Med. 2009;169:1381–8.

    Article  Google Scholar 

  • Metzger ML, Hudson MM, Somes GW, et al. White race as a risk factor for hypothyroidism after treatment for pediatric Hodgkin’s lymphoma. J Clin Oncol. 2006a;24:1516–21.

    Article  PubMed  Google Scholar 

  • Metzger ML, Howard SC, Hudson MM, et al. Natural history of thyroid nodules in survivors of pediatric Hodgkin’s lymphoma. Pediatr Blood Cancer. 2006b;46:314–9.

    Article  PubMed  Google Scholar 

  • Molitch ME, Clemmons DE, Malozowski S, et al. Evaluation and treatment of adult growth hormone deficiency: an Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2006;91:1621–34.

    Article  CAS  PubMed  Google Scholar 

  • Nandagopal R, Laverdière C, Mulrooney D, et al. Endocrine late effects of childhood cancertherapy: a report from the Children’s Oncology Group. Horm Res. 2008;69:65–74.

    Article  CAS  PubMed  Google Scholar 

  • Oeffinger KC, Mertens AC, Sklar CA, et al. Chronic health conditions in adult survivors of childhood cancer. N Engl J Med. 2006;355:1572–82.

    Article  CAS  PubMed  Google Scholar 

  • Patterson BC, Truxillo L, Wasilewski-Masker K, et al. Adrenal function testing in pediatric cancer survivors. Pediatr Blood Cancer. 2009;53:1302–7.

    Article  PubMed  Google Scholar 

  • Patterson BC, Wasilewski-Masker K, Ryerson AB, et al. Endocrine health problems detected in 519 patients evaluated in a pediatric cancer survivor program. J Clin Endocrinol Metab. 2012;97:810–8.

    Article  CAS  PubMed  Google Scholar 

  • Romerius P, Ståhl O, Moëll C, et al. Hypogonadism risk in men treated for childhood cancer. J Clin Endocrinol Metab. 2009;94:4180–6.

    Article  CAS  PubMed  Google Scholar 

  • Sigurdson AJ, Ronckers CM, Mertens AC, et al. Primary thyroid cancer after a first tumo rin childhood (the Childhood Cancer Survivor Study): a nested case-control study. Lancet. 2005;365:2014–23.

    Article  PubMed  Google Scholar 

  • Sigurjonssdottir T, Hayes A. Precocious puberty: a report of 96 cases. Am J Dis Child. 1968;1115:309–21.

    Article  Google Scholar 

  • Sklar CA, Mertens AC, Walter A, et al. Changes in body mass index and prevalence of overweight in survivors of childhood acute lymphoblastic leukemia: role of cranial irradiation. Med Pediatr Oncol. 2000a;35:91–5.

    Article  CAS  PubMed  Google Scholar 

  • Sklar C, Whitton J, Mertens A, et al. Abnormalities of the thyroid in survivors of Hodgkin’s disease: data from the Childhood Cancer Survivor Study. J Clin Endocrinol Metab. 2000b;85:3227–32.

    CAS  PubMed  Google Scholar 

  • Sklar CA, Mertens AC, Mitby P, et al. Premature menopause in survivors of childhood cancer: a report from the Childhood Cancer Survivor Study. J Natl Cancer Inst. 2006;98:890–6.

    Article  PubMed  Google Scholar 

  • Wasilewski-Masker K, Kaste SC, Hudson MM, et al. Bone mineral density deficits in survivors of childhood cancer: long-term follow-up guidelines and review of the literature. Pediatrics. 2008;121:e705–13.

    Article  PubMed  Google Scholar 

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Acknowledgment

KCJY has received research grants from Pfizer, Novo Nordisk, Eli Lilly, and Versartis, and has served on the advisory boards for Pfizer, Novo Nordisk and Corcept Therapeutics.

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Authors and Affiliations

  1. Swedish Pituitary Center, Swedish Neuroscience Institute, 550 17th Avenue, 98122, Seattle, WA, USA

    Kevin C. J. Yuen MBChB, MD, FRCP (UK)

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  1. Kevin C. J. Yuen MBChB, MD, FRCP (UK)
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Correspondence to Kevin C. J. Yuen MBChB, MD, FRCP (UK) .

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Editors and Affiliations

  1. Knight Cancer Institute Adult Blood and Marrow Stem Cell Transplant Program, Oregon Health & Science University Center for Hematologic Malignancies, Portland, Oregon, USA

    Richard T. Maziarz

  2. Knight Cancer Institute Adult Blood and Marrow Stem Cell Transplant Program, Oregon Health & Science University Center for Hematologic Malignancies, Portland, Oregon, USA

    Susan Schubach Slater

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Yuen, K. (2015). Endocrine Complications in Childhood Cancer Survivors. In: Maziarz, R., Slater, S. (eds) Blood and Marrow Transplant Handbook. Springer, Cham. https://doi.org/10.1007/978-3-319-13832-9_26

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  • DOI: https://doi.org/10.1007/978-3-319-13832-9_26

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-13831-2

  • Online ISBN: 978-3-319-13832-9

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