[儿童和青少年骨髓移植的内分泌后遗症]。

Annales de pediatrie Pub Date : 1993-09-01
B Le Heup, A von Bueltzingloewen, P Bordigoni, D Sommelet, M Pierson
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引用次数: 0

摘要

骨髓移植越来越多地用于治疗各种严重的儿科疾病,包括血液学、代谢和免疫疾病。常见的不良反应是人体生长减慢,根据作者的经验,在具有进行性移植物抗宿主病的最高风险组中,全身照射和移植同种异体移植物后,平均每年达到0.4 SD。接受中等强度化疗的自体移植物生长正常。据报道,大剂量化疗,特别是用丁硫凡和环磷酰胺,可导致生长迟缓。无法长高的机制是复杂的。部分生长激素缺乏是罕见的。生长板的相对阻力是最可能的机制。生长激素替代疗法的作用和疗效尚不清楚。调理方案会影响卵巢和睾丸功能。全身照射和同种异体移植后可发生外周甲状腺抵抗。高生长率和内分泌紊乱需要密切监测,包括对生长和青春期发育的全面评估以及定期的内分泌调查。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Endocrinal sequela in bone marrow transplantations during childhood and adolescence].

Bone marrow transplants are being increasingly used to treat a broadening spectrum of serious pediatric conditions including hematologic, metabolic, and immune disorders. A common adverse effect is slowing of statural growth which, according to the author's experience, reaches 0.4 SD a year on average in the highest risk group with progressive graft-versus-host disease after whole body irradiation and transplantation of an allograft. Growth was normal in autograft recipients treated by moderate-intensity chemotherapy. High-dose chemotherapy, in particular with busulfan and cyclophosphamide, has been reported to cause growth retardation. The mechanism of failure to gain height is complex. Partial growth hormone deficiency is rare. Relative resistance of growth plates is the most likely mechanism. The role and efficacy of growth hormone replacement therapy is unclear. Conditioning regimens can affect ovarian and testicular function. Peripheral thyroid resistance can occur after whole body irradiation and transplantation of an allograft. The high rate of growth and endocrine disorders warrants close monitoring including full evaluations of growth and pubertal development as well as periodic endocrinologic investigations.

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