Cristina Garcés-Visier , Paloma Conejero-Gonzalez , Maitane Andión-Catalán , Alberto Martín-Vega , Diego Muñoz-Hernández , Manuel Leónidas Espinoza-Vega , Ana Lourdes Luis-Huertas , José Lorenzo Alonso-Calderón
{"title":"霍奇金淋巴瘤患者的甲状腺异常:密切监测的重要性","authors":"Cristina Garcés-Visier , Paloma Conejero-Gonzalez , Maitane Andión-Catalán , Alberto Martín-Vega , Diego Muñoz-Hernández , Manuel Leónidas Espinoza-Vega , Ana Lourdes Luis-Huertas , José Lorenzo Alonso-Calderón","doi":"10.1016/j.anpedi.2024.01.007","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction</h3><p>Survival in paediatric patients with Hodgkin lymphoma (HL) has increased over the last decades. However, these patients are at increased risk of developing late thyroid sequelae due to the treatment with irradiation and alkylating agents.</p></div><div><h3>Methods</h3><p>We conducted an observational and retrospective study in patients with a diagnosis of HL between 2007 and 2022, in a hospital that is a paediatric oncology reference centre, through the review of electronic health records. We collected data on demographic (age, sex), clinical, radiological and histopathological variables, the dosage of alkylating agents and radiotherapy (RT) and on thyroid disorders using Microsoft Excel®. The data analysis was conducted with SPSS version 17, using the Fisher exact test for qualitative data, a nonparametric test for quantitative data and Kaplan-Meier curves.</p></div><div><h3>Results</h3><p>Sixty patients received a diagnosis of HL from 2007 to 2022. The median duration of followup was 78.5 months. There were 4 detected cases of hypothyroidism, 5 of thyroid nodules and 1 of subclinical hyperthyroidism. Treatment with RT was significantly associated with the development of hypothyroidism (<em>P=</em>.026), thyroid nodules (<em>P=</em>.01) and thyroid disease overall (<em>P=</em>.003). We estimated that the risk of thyroid disease increased 8-fold with each additional Grey received (hazard ratio, 1.081; 95% CI, 1.014-1.152; <em>P=</em>.017).</p></div><div><h3>Conclusion</h3><p>Hodgkin lymphoma patients treated with RT are at increased risk of late thyroid disorders, mainly hypothyroidism and malignancy. This risk is greater the higher the RT dosage and the longer the followup. We did not find evidence of an association between the use of alkylating agents and an increase in the risk of thyroid disease.</p></div>","PeriodicalId":7783,"journal":{"name":"Anales de pediatria","volume":null,"pages":null},"PeriodicalIF":1.5000,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1695403324000122/pdfft?md5=a6b749e1037ad23e613cbd6609374d8c&pid=1-s2.0-S1695403324000122-main.pdf","citationCount":"0","resultStr":"{\"title\":\"Alteraciones tiroideas en pacientes con linfoma de Hodgkin: la importancia de la vigilancia estrecha\",\"authors\":\"Cristina Garcés-Visier , Paloma Conejero-Gonzalez , Maitane Andión-Catalán , Alberto Martín-Vega , Diego Muñoz-Hernández , Manuel Leónidas Espinoza-Vega , Ana Lourdes Luis-Huertas , José Lorenzo Alonso-Calderón\",\"doi\":\"10.1016/j.anpedi.2024.01.007\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Introduction</h3><p>Survival in paediatric patients with Hodgkin lymphoma (HL) has increased over the last decades. However, these patients are at increased risk of developing late thyroid sequelae due to the treatment with irradiation and alkylating agents.</p></div><div><h3>Methods</h3><p>We conducted an observational and retrospective study in patients with a diagnosis of HL between 2007 and 2022, in a hospital that is a paediatric oncology reference centre, through the review of electronic health records. We collected data on demographic (age, sex), clinical, radiological and histopathological variables, the dosage of alkylating agents and radiotherapy (RT) and on thyroid disorders using Microsoft Excel®. The data analysis was conducted with SPSS version 17, using the Fisher exact test for qualitative data, a nonparametric test for quantitative data and Kaplan-Meier curves.</p></div><div><h3>Results</h3><p>Sixty patients received a diagnosis of HL from 2007 to 2022. The median duration of followup was 78.5 months. There were 4 detected cases of hypothyroidism, 5 of thyroid nodules and 1 of subclinical hyperthyroidism. Treatment with RT was significantly associated with the development of hypothyroidism (<em>P=</em>.026), thyroid nodules (<em>P=</em>.01) and thyroid disease overall (<em>P=</em>.003). We estimated that the risk of thyroid disease increased 8-fold with each additional Grey received (hazard ratio, 1.081; 95% CI, 1.014-1.152; <em>P=</em>.017).</p></div><div><h3>Conclusion</h3><p>Hodgkin lymphoma patients treated with RT are at increased risk of late thyroid disorders, mainly hypothyroidism and malignancy. This risk is greater the higher the RT dosage and the longer the followup. We did not find evidence of an association between the use of alkylating agents and an increase in the risk of thyroid disease.</p></div>\",\"PeriodicalId\":7783,\"journal\":{\"name\":\"Anales de pediatria\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.5000,\"publicationDate\":\"2024-05-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.sciencedirect.com/science/article/pii/S1695403324000122/pdfft?md5=a6b749e1037ad23e613cbd6609374d8c&pid=1-s2.0-S1695403324000122-main.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Anales de pediatria\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S1695403324000122\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"PEDIATRICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Anales de pediatria","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1695403324000122","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PEDIATRICS","Score":null,"Total":0}
Alteraciones tiroideas en pacientes con linfoma de Hodgkin: la importancia de la vigilancia estrecha
Introduction
Survival in paediatric patients with Hodgkin lymphoma (HL) has increased over the last decades. However, these patients are at increased risk of developing late thyroid sequelae due to the treatment with irradiation and alkylating agents.
Methods
We conducted an observational and retrospective study in patients with a diagnosis of HL between 2007 and 2022, in a hospital that is a paediatric oncology reference centre, through the review of electronic health records. We collected data on demographic (age, sex), clinical, radiological and histopathological variables, the dosage of alkylating agents and radiotherapy (RT) and on thyroid disorders using Microsoft Excel®. The data analysis was conducted with SPSS version 17, using the Fisher exact test for qualitative data, a nonparametric test for quantitative data and Kaplan-Meier curves.
Results
Sixty patients received a diagnosis of HL from 2007 to 2022. The median duration of followup was 78.5 months. There were 4 detected cases of hypothyroidism, 5 of thyroid nodules and 1 of subclinical hyperthyroidism. Treatment with RT was significantly associated with the development of hypothyroidism (P=.026), thyroid nodules (P=.01) and thyroid disease overall (P=.003). We estimated that the risk of thyroid disease increased 8-fold with each additional Grey received (hazard ratio, 1.081; 95% CI, 1.014-1.152; P=.017).
Conclusion
Hodgkin lymphoma patients treated with RT are at increased risk of late thyroid disorders, mainly hypothyroidism and malignancy. This risk is greater the higher the RT dosage and the longer the followup. We did not find evidence of an association between the use of alkylating agents and an increase in the risk of thyroid disease.
期刊介绍:
La Asociación Española de Pediatría tiene como uno de sus objetivos principales la difusión de información científica rigurosa y actualizada sobre las distintas áreas de la pediatría. Anales de Pediatría es el Órgano de Expresión Científica de la Asociación y constituye el vehículo a través del cual se comunican los asociados. Publica trabajos originales sobre investigación clínica en pediatría procedentes de España y países latinoamericanos, así como artículos de revisión elaborados por los mejores profesionales de cada especialidad, las comunicaciones del congreso anual y los libros de actas de la Asociación, y guías de actuación elaboradas por las diferentes Sociedades/Secciones Especializadas integradas en la Asociación Española de Pediatría.