{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,8]],"date-time":"2026-02-08T09:03:41Z","timestamp":1770541421326,"version":"3.49.0"},"reference-count":46,"publisher":"The Endocrine Society","issue":"12","funder":[{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"(NHLBI)","doi-asserted-by":"crossref","award":["HL006007-16"],"award-info":[{"award-number":["HL006007-16"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000050","name":"(NHLBI)","doi-asserted-by":"crossref","award":["HL006211-08"],"award-info":[{"award-number":["HL006211-08"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Cooperative Study of Late Effects for SCD Curative Therapies","award":["1U01HL156620-01"],"award-info":[{"award-number":["1U01HL156620-01"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,11,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Purpose<\/jats:title>\n                  <jats:p>To determine the rate and clinical characteristics associated with abnormal thyroid and adrenal function in recipients of nonmyeloablative hematopoietic cell transplantation (HCT) for sickle cell disease (SCD) and beta-thalassemia.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We retrospectively reviewed patients who enrolled in 4 nonmyeloablative HCT regimens with alemtuzumab and total body irradiation (TBI). Baseline and annual post-HCT data were compared, which included age, sex, sickle phenotype, thyroid panel (total T3, free T4, thyroid stimulating hormone, antithyroid antibodies), cortisol level, ACTH stimulation testing, ferritin, medications, and other relevant medical history.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Among 43 patients in haploidentical transplant and 84 patients in the matched related donor protocols with mostly SCD, the rate of any thyroid disorder pre-HCT was 3.1% (all subclinical hypothyroidism) and post-HCT was 29% (10 hypothyroidism, 4 Grave's disease, and 22 subclinical hypothyroidism). Ninety-two (72%) patients had ferritin &amp;gt;1000\u2005ng\/dL, of which 33 patients (35.8%) had thyroid dysfunction. Iron overload was noted in 6 of 10 patients with hypothyroidism and 12 of 22 patients with subclinical hypothyroidism.<\/jats:p>\n                  <jats:p>Sixty-one percent were on narcotics for pain control. With respect to adrenal insufficiency (AI) pre-HCT, 2 patients were maintained on corticosteroids for underlying rheumatologic disorder and 8 had AI diagnosed during pre-HCT ACTH stimulation testing (total 10, 7.9%). Post-HCT, an additional 4 (3%) developed AI from corticosteroid use for acute graft vs host disease, Evans syndrome, or hemolytic anemia.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Although iron overload was common in SCD, thyroid dysfunction pre-HCT related to excess iron was less common. Exposure to alemtuzumab or TBI increased the rates of thyroid dysfunction post-HCT. In contrast, AI was more common pre-HCT, but no risk factor was identified. AI post-HCT was infrequent and associated with corticosteroid use for HCT-related complications.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1210\/jendso\/bvad134","type":"journal-article","created":{"date-parts":[[2023,11,5]],"date-time":"2023-11-05T06:48:15Z","timestamp":1699166895000},"source":"Crossref","is-referenced-by-count":5,"title":["Thyroid and Adrenal Dysfunction in Hemoglobinopathies Before and After Allogeneic Hematopoietic Cell Transplant"],"prefix":"10.1210","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3734-1215","authenticated-orcid":false,"given":"Mamatha","family":"Mandava","sequence":"first","affiliation":[{"name":"Immunodeficiency and Cell Therapy Program (IDCTP), National Cancer Institute\/National Institutes of Health , Bethesda, MD 20892 , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffrey","family":"Lew","sequence":"additional","affiliation":[{"name":"Hematology\/Oncology, Department of Internal Medicine, Womack Army Medical Center , Fort Liberty, NC 28310 , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John F","family":"Tisdale","sequence":"additional","affiliation":[{"name":"Cellular and Molecular Therapeutics Branch, National Heart, Lung, and Blood Institute\/National Institutes of Health , Bethesda, MD 20892 , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emily","family":"Limerick","sequence":"additional","affiliation":[{"name":"Cellular and Molecular Therapeutics Branch, National Heart, Lung, and Blood Institute\/National Institutes of Health , Bethesda, MD 20892 , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Courtney D","family":"Fitzhugh","sequence":"additional","affiliation":[{"name":"Cellular and Molecular Therapeutics Branch, National Heart, Lung, and Blood Institute\/National Institutes of Health , Bethesda, MD 20892 , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew M","family":"Hsieh","sequence":"additional","affiliation":[{"name":"Cellular and Molecular Therapeutics Branch, National Heart, Lung, and Blood Institute\/National Institutes of Health , Bethesda, MD 20892 , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"80","published-online":{"date-parts":[[2023,10,31]]},"reference":[{"issue":"13","key":"2023120107073882000_bvad134-B1","doi-asserted-by":"crossref","first-page":"1645","DOI":"10.1001\/jama.289.13.1645","article-title":"Effect of hydroxyurea on mortality and morbidity in adult sickle cell anemia: risks and benefits up to 9 years of treatment","volume":"289","author":"Steinberg","year":"2003","journal-title":"JAMA"},{"issue":"12","key":"2023120107073882000_bvad134-B2","doi-asserted-by":"crossref","first-page":"2354","DOI":"10.1182\/blood-2009-05-221333","article-title":"The effect of prolonged administration of hydroxyurea on morbidity and mortality in adult patients with sickle cell syndromes: results of a 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