White race as a risk factor for hypothyroidism after treatment for pediatric Hodgkin's lymphoma

Monika L. Metzger, Melissa M. Hudson, Grant W. Somes, Ron I. Shorr, Chin-Shang Li, Matthew J. Krasin, John Shelso, Ching Hon Pui, Scott C. Howard

Research output: Contribution to journalArticle

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Abstract

Purpose: Hypothyroidism frequently occurs after treatment for pediatric Hodgkin's lymphoma, but race has not been investigated as a risk factor for this delayed toxicity. The aim of this study was to determine whether race is an independent risk factor for hypothyroidism in survivors of pediatric Hodgkin's lymphoma. Patients and Methods: To identify differences between black and white patients in the development of hypothyroidism after treatment for Hodgkin's lymphoma, we conducted a retrospective study of consecutively treated pediatric patients with newly diagnosed Hodgkin's lymphoma treated at St Jude Children's Research Hospital (Memphis, TN) from January 1980 through December 2002. Clinical or biochemical hypothyroidism was defined by an above normal thyroxine-stimulating hormone concentration or by the need for thyroid hormone replacement therapy. Results: The 461 patients (388 white patients, 73 black patients) where followed for a median of 11.3 years (range, 1.8 to 24.9 years). Hypothyroidism developed in 196 (43%) of 461 patients after a median of 2.9 years (range, 0.7 to 11.3 years) after diagnosis of Hodgkin's lymphoma. Hypothyroidism developed in 47% of white patients but in only 21 % of black patients (hazard ratio = 2.7; 95% CI, 1.6 to 4.6). After adjusting for other risk factors for hypothyroidism (thyroid radiation dose, sex, and nodular sclerosis histology), the risk of hypothyroidism in white patients was 2.5 times (95% CI, 1.5 to 4.3 times) the risk in black patients (P < .001). Conclusion: White patients have a higher risk of hypothyroidism after neck irradiation for pediatric Hodgkin's lymphoma than black patients.

Original languageEnglish (US)
Pages (from-to)1516-1521
Number of pages6
JournalJournal of Clinical Oncology
Volume24
Issue number10
DOIs
StatePublished - Apr 1 2006
Externally publishedYes

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Hypothyroidism
Hodgkin Disease
Pediatrics
Therapeutics
Hormone Replacement Therapy
Sclerosis
Thyroxine
Thyroid Hormones
Survivors
Histology
Thyroid Gland
Neck
Retrospective Studies
Hormones
Radiation

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Metzger, M. L., Hudson, M. M., Somes, G. W., Shorr, R. I., Li, C-S., Krasin, M. J., ... Howard, S. C. (2006). White race as a risk factor for hypothyroidism after treatment for pediatric Hodgkin's lymphoma. Journal of Clinical Oncology, 24(10), 1516-1521. https://doi.org/10.1200/JCO.2005.05.0195

White race as a risk factor for hypothyroidism after treatment for pediatric Hodgkin's lymphoma. / Metzger, Monika L.; Hudson, Melissa M.; Somes, Grant W.; Shorr, Ron I.; Li, Chin-Shang; Krasin, Matthew J.; Shelso, John; Pui, Ching Hon; Howard, Scott C.

In: Journal of Clinical Oncology, Vol. 24, No. 10, 01.04.2006, p. 1516-1521.

Research output: Contribution to journalArticle

Metzger, ML, Hudson, MM, Somes, GW, Shorr, RI, Li, C-S, Krasin, MJ, Shelso, J, Pui, CH & Howard, SC 2006, 'White race as a risk factor for hypothyroidism after treatment for pediatric Hodgkin's lymphoma', Journal of Clinical Oncology, vol. 24, no. 10, pp. 1516-1521. https://doi.org/10.1200/JCO.2005.05.0195
Metzger, Monika L. ; Hudson, Melissa M. ; Somes, Grant W. ; Shorr, Ron I. ; Li, Chin-Shang ; Krasin, Matthew J. ; Shelso, John ; Pui, Ching Hon ; Howard, Scott C. / White race as a risk factor for hypothyroidism after treatment for pediatric Hodgkin's lymphoma. In: Journal of Clinical Oncology. 2006 ; Vol. 24, No. 10. pp. 1516-1521.
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AU - Hudson, Melissa M.

AU - Somes, Grant W.

AU - Shorr, Ron I.

AU - Li, Chin-Shang

AU - Krasin, Matthew J.

AU - Shelso, John

AU - Pui, Ching Hon

AU - Howard, Scott C.

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N2 - Purpose: Hypothyroidism frequently occurs after treatment for pediatric Hodgkin's lymphoma, but race has not been investigated as a risk factor for this delayed toxicity. The aim of this study was to determine whether race is an independent risk factor for hypothyroidism in survivors of pediatric Hodgkin's lymphoma. Patients and Methods: To identify differences between black and white patients in the development of hypothyroidism after treatment for Hodgkin's lymphoma, we conducted a retrospective study of consecutively treated pediatric patients with newly diagnosed Hodgkin's lymphoma treated at St Jude Children's Research Hospital (Memphis, TN) from January 1980 through December 2002. Clinical or biochemical hypothyroidism was defined by an above normal thyroxine-stimulating hormone concentration or by the need for thyroid hormone replacement therapy. Results: The 461 patients (388 white patients, 73 black patients) where followed for a median of 11.3 years (range, 1.8 to 24.9 years). Hypothyroidism developed in 196 (43%) of 461 patients after a median of 2.9 years (range, 0.7 to 11.3 years) after diagnosis of Hodgkin's lymphoma. Hypothyroidism developed in 47% of white patients but in only 21 % of black patients (hazard ratio = 2.7; 95% CI, 1.6 to 4.6). After adjusting for other risk factors for hypothyroidism (thyroid radiation dose, sex, and nodular sclerosis histology), the risk of hypothyroidism in white patients was 2.5 times (95% CI, 1.5 to 4.3 times) the risk in black patients (P < .001). Conclusion: White patients have a higher risk of hypothyroidism after neck irradiation for pediatric Hodgkin's lymphoma than black patients.

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