Table 3.

Endocrinology monitoring before and after hematopoietic cell transplantation (1–5)

	Clinical	Yearly Laboratory
	Endocrinology visit
Growth	Yearly height (every 6 mo under age 10y)
Weight	Yearly weight (every 6 mo under age 10y)
Adrenal	After prolonged corticosteroid usage, slow terminal tapering of steroids; stress doses of steroids during acute illness	Consider ACTH stimulation testing
Thyroid	Growth rate	Free T4, TSH
Bone	Comprehensive nutrition history and monitoring, with attention to milk intake, vitamins, exercise	25OH-vitamin D
		DXA at one year after HSCT, then every 5 years, more often if abnormal
Gonadal	Pubertal staging History for development of body odor, acne, facial hair, breast size, pubic hair, testes size, menses, erections, libido, sexual function, hot flashes	Child—x-ray for bone age if early or late Female—LH, FSH, Estradiol, AMH Male—LH, FSH, Testosterone, Inhibin B

Thyroxine, T4; thyroid-stimulating hormone, TSH; dual-energy X-ray absorptiometry, DXA; luteinizing hormone, LH; follicle stimulating hormone, FSH; anti-mullerian hormone, AMH

1. Majhail NS, Rizzo JD, Lee SJ, et al. Recommended screening and preventive practices for long-term survivors after hematopoietic cell transplantation. Revista Brasileira de Hematologia e Hemoterapia 2012;34:109–133.

2. BM B, SM S. Endocrine late effects after bone marrow transplant. Br J Haematol 2002;118:58–66.

3. Sanders JE, Hoffmeister PA, Woolfrey AE, et al. Thyroid function following hematopoietic cell transplantation in children: 30 years’ experience; 2009.

4. Ranke MB, Schwarze CP, Dopfer R, et al. Late effects after stem cell transplantation (SCT) in children--growth and hormones. Bone Marrow Transplant 2005;35 Suppl 1:S77–81.

5. Sanders JE. Endocrine complications of high-dose therapy with stem cell transplantation. Pediatric Transplantation 2004;8 Suppl 5:39–50.