2018 年 7 巻 3 号 p. 90-97
To elucidate late effects of reduced intensity stem cell transplantation (RIST) in childhood cancer survivors, we retrospectively examined late effects, primarily endocrine disorders, in 23 patients who underwent RIST and 12 patients who underwent myeloablative stem cell transplantation (MAST). After RIST, the overall rate of late effects was 69.6% and its severity mostly ranged from mild to moderate. After MAST, all patients had some late effects and its severity was severe or life threatening. The severity of late effects was clearly reduced in RIST. Endocrine late effects after RIST were growth disorders in eight patients (35.0%) and thyroid dysfunction in three patients (13.0%). After MAST, endocrine late effects were growth disorders in three patients (25.0%) and thyroid dysfunction in one patients (8.3%). There was no significant difference following RIST or MAST. Concerning gonadal dysfunction among patients who reached puberty, the prevalence rate was higher after MAST than after RIST. In girls after RIST, 37.5% were considered as having ovarian dysfunction on evaluation of anti-Müllerian hormone levels. We found that RIST reduced late effects; however, endocrine disorders such as gonadal dysfunction were still very common. Further improvement of transplantation conditioning and continued long-term follow-up are needed.