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Minerva Pediatrica 2016 Jul 14


language: English

How is the relation between endocrine changes and bone markers in pediatric thalassemic patients after Hematopoietic Stem Cell Transplantation

Amir A. HAMIDIEH 1, Zohreh HAMIDI 2, Maryam BEHFAR 1, Zeinab PAJOUHI 2, Kamran ALIMOGHADDAM 1, Fariba MOHSENI 2, Ardeshir GHAVAMZADEH 1, Maryam SOBHANI 2, Bagher LARIJANI 2, Mohammad R. MOHAJERI TEHRANI 2

1 Hematology-Oncology and Stem Cell Transplantation Research Center of Tehran University of Medical Sciences, Tehran, Iran; 2 Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran


BACKGROUNDS: Beta Thalassemia Major, and its treatment by hematopoietic stem cell transplantation can have deleterious effect on bone integrity and a main part of such effects is due to their deleterious effects on endocrine systems. So, we assessed the effects of endocrine changes during HSCT (Hematopoietic Stem Cell Transplantation) on growing bones of pediatric thalassemic patients.
METHODS: Bone-specific alkaline phosphatase and osteocalcin (bone formation markers), NTX (bone resorption marker), Ca, P, Alk ph, PTH, Vitamin D (vit D), prolactin, LH, FSH, T4, T3, TSH, IGF-1, testosterone (in males) or estradiol (in females), measured in 20 major thalassemic patients with mean age of 10.8 ± 3.9 y/o. Parameters at the baseline (before HSCT), and 1 month and 3 months after HSCT.
RESULTS: After stem cell transplantation, changes of mean serum levels of NTX, osteocalcin, prolactin, LH ,T4, IGF-1 , testosterone (in males), Ca, Alk ph, PTH and Vit D were not significant, but bone specific alkalin phosphatase, Phosphorus, T3, TSH, FSH and estradiol changed significantly (p= 0.013, 0.001, 0.48, 0.02, 0.04 and 0.001, respectively). After one month, there was a significant positive relationship between osteocalcine and T3 (p= 0.009). After 3 months, also, there was a significant positive relationship between osteocalcine and T3 and T4 as well as a negative ones with IGF1 (p < 0.001, 0.02 and 0.03, respectively).
CONCLUSIONS: Endocrine disorders do not appear to have an overall positive or negative effect on bone metabolism (anabolism or catabolism) in HSCT pediatric thalassemic patients in short term (three months).

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