Evaluation of short-term endocrinological complications in children with acute leukemia by risk groups

Evaluation of Short-Term Endocrinological Complications in Children with Acute Leukemia by Risk Groups Objectives: The survival rate of patients with acute leukemia has increased significantly with the treatment protocols developed in recent years. This increase in survival rate causes treatment-related complications. Long-term follow-up of survivors with a diagnosis of leukemia is important in terms of these complications. In our study, it was aimed to evaluate the endocrinological complications that may occur after treatment in patients with acute leukemia, and to contribute to early diagnosis and treatment methods. Design and Methods: A total of 37 patients under the age of 18 who were diagnosed with acute leukemia between the years 2021-2023 in the Department of Pediatric Hematology and Oncology at Akdeniz University Medical Faculty Hospital were included in our study. From all patients; age, gender, height, weight, body mass index (BMI), free T3, free T4, thyroid stimulating hormone (TSH), insulin, glucose, adrenocorticotropic hormone (ACTH), cortisol, 25- Hydroxy Vitamin D3, parathyroid hormone (PTH) ), calcium, phosphorus, alkaline phosphatase, magnesium, total cholesterol, triglyceride, low-density lipoprotein (LDL), high-density lipoprotein (HDL), follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol in girls older than 8 years, FSH, LH, testosterone in boys older than 9 years were collected. Results: The median age of the patients at the time of diagnosis and at the time of the study was 5 years was 5,29 years (IQR: 2,81-7,06) and 6,68 years (IQR: 4,5- 8,8), respectively. At least two complications was observed in 100% of patients. Short stature (59,5%) was the most frequent endocrine complication. Other endocrine complications increased LDL levels (%45,9), adrenal insufficiency (40,5%), increased triglyceride levels (40,5%), vitamin D deficiency (35,1%), obesity (32,4%) and hypoglycemia/hiperglycemia (10,8%). There were no statistically significant correlations between endocrine complications and age. Short stature was significantly more frequent in prepubertal ALL survivors compared to pubertal ALL survivors (p=0,042). However, short stature was more common in girls compared to boys (p=0.032). The number of patients who developed hypertriglyceridemia was significantly higher in the pubertal group (p=0.042). Conclusions: In current study, a high frequency of endocrine complications was observed at the end of the treatment in patients with acute leukemia. Patients with acute leukemia should be followed up for life-long possible endocrine complications for early diagnosis and treatment strategies. Keywords: Acute lymphoblastic leukemia, Endocrine, Complication