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Hormonal Evaluation Of Patients With Sickle Cell Disease Who Underwent Allogeneic Hematopoietic Stem Cell Transplantation

Friday, November 08, 2013 — Poster Session III

10:00 a.m. – 12:00 p.m.

FAES Academic Center (Upper-Level Terrace)




  • H. Gharwan
  • M.M. Hsieh
  • M. Link
  • W. Coles
  • C.D. Fitzhugh
  • J.F. Tisdale


Despite improved medical management of sickle cell disease (SCD), hematopoietic stem cell transplantation (HSCT) remains the only curative treatment. Standard myeloablative preparatory conditioning regimens frequently lead to hormonal abnormalities. Our group performed allogeneic HSCT in 14 female (ages 20 - 47 years) and 17 male (ages 16 - 64 years) patients with SCD using a non-myeloablative regimen: lower doses of total body irradiation (300 cGy instead of standard 2000 cGy), and alemtuzumab and sirolimus instead of chemotherapy. Additionally, the gonads of male patients were shielded to reduce radiation exposure. The endocrine function of several patients before, and at various time points up to 12 months after transplantation was analyzed. TSH values of those patients were lower, albeit normal, after transplantation, while free triiodothyronine levels rose correspondingly. Furthermore, male gonadal function was not impacted measurably, but evaluated females had higher pituitary hormone levels (LH, FSH) and lower estradiol levels at one year after transplantation, consistent with reduced/diminished ovarian function. Nonetheless, pregnancies occurred in two females younger than 35 years, indicating that fertility is preserved in a subset of women. Further investigation of these patients is required to understand how to better preserve female gonadal function in the setting of HSCT.

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