Endocrine Health Problems Detected in 764 Patients Evaluated in a Late Effects Clinic

BACKGROUND: Many pediatric cancer survivors have endocrine conditions. After treatment with alkylating agents, steroids, methotrexate, and radiation, several endocrine dysfunctions may appear. Surveillance for late effects is recommended by guidelines worldwide. OBJECTIVE: The objective of this study was to describe the endocrine outcomes of 764 patients followed during a 20 years' period in our out-patient clinic. DESIGN: We retrospectively reviewed the medical records. PATIENTS: The study included 764 patients whose oncological or hematological dangerous diseases appeared before they were 18 years old. Larger groups were constituted by leukemias, central nervous tumors, and lymphomas. OUTCOME MEASURES: The frequency and types of endocrine conditions were analyzed. RESULTS: 1,091 endocrine conditions were observed in all groups. The most common types of endocrine conditions were problems with growth and the thyroid. We found puberty abnormalities and bone problems in third and fourth places of frequency. ACTH insufficiency was found in seventh place. CONCLUSION: Endocrine dysfunctions are very common in survivor populations. Endocrinologists should be aware of international guidelines and make an effort to optimize screening and treatment of endocrine effects of cancer therapy. The crucial period is the puberty with growth spurt failure and accelerated maturity both of which can bring future social and professional difficulties.