BACKGROUND: Inborn errors of immunity (IEI) with dysregulated JAK/STAT signaling present with variable manifestations of immune dysregulation and infections. Hematopoietic stem cell transplantation (HSCT) is potentially curative, but initially reported outcomes were poor. JAK inhibitors (JAKi) offer a targeted treatment option that may be an alternative or bridge to HSCT. However, data on their current use, treatment efficacy and adverse events are limited. OBJECTIVE: We evaluated the current off-label JAKi treatment experience for JAK/STAT inborn errors of immunity (IEI) among European Society for Immunodeficiencies (ESID)/European Society for Blood and Marrow Transplantation (EBMT) Inborn Errors Working Party (IEWP) centers. METHODS: We conducted a multicenter retrospective study on patients with a genetic disorder of hyperactive JAK/STAT signaling who received JAKi treatment for at least 3 months. RESULTS: Sixty-nine patients (72% children) were evaluated (45 STAT1 gain of function [GOF], 21 STAT3-GOF, 1 STAT5B-GOF, 1 suppressor of cytokine signaling 1 [aka SOCS1] loss of function, 1 JAK1-GOF). Ruxolitinib was the predominantly prescribed JAKi (80%). Overall, treatment resulted in improvement (partial or complete remission) of clinical symptoms in 87% of STAT1-GOF and in 90% of STAT3-GOF patients. We documented highly heterogeneous dosing and monitoring regimens. The response rate and time to response varied across different diseases and manifestations. Adverse events including infection and weight gain were frequent (38% of patients) but were mild (grade I-II) and transient in most patients. At last follow-up, 52 (74%) of 69 patients were still receiving JAKi treatment, and 11 patients eventually underwent HSCT after receipt of previous JAKi bridging therapy, with 91% overall survival. CONCLUSIONS: Our study suggests that JAKi may be highly effective to treat symptomatic JAK/STAT IEI patients. Prospective studies to define optimal JAKi dosing for the variable clinical presentations and age ranges should be pursued.

• MeSH
• Child MeSH
• Janus Kinase Inhibitors * therapeutic use   MeSH
• Humans MeSH
• Prospective Studies MeSH
• Retrospective Studies MeSH
• Immunologic Deficiency Syndromes * therapy   MeSH
• Treatment Outcome MeSH
• Check Tag
• Child MeSH
• Humans MeSH
• Publication type
• Journal Article MeSH
• Multicenter Study MeSH
• Research Support, Non-U.S. Gov't MeSH

• MeSH
• Granuloma etiology   diagnosis   MeSH
• Humans MeSH
• Nijmegen Breakage Syndrome * genetics   MeSH
• Severe Combined Immunodeficiency * therapy   complications   diagnosis   MeSH
• Hematopoietic Stem Cell Transplantation * adverse effects   MeSH
• Treatment Outcome MeSH
• Check Tag
• Humans MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Letter MeSH
• Case Reports MeSH

Severe combined immunodeficiency (SCID) screening je souhrnný název pro nástroj časné detekce řady závažných vrozených poruch imunity. Současná kvantifikace excizních DNA molekul TREC a KREC umožňuje časně diagnostikovat závažné buněčné i protilátkové vrozené defekty imunity. Do dvouletého pilotního programu screeningu se v letech 2022–2023 v České republice zapojilo > 90 % novorozenců (vyšetřeno bylo 198 675 vzorků). Diagnostikováni byli 2 pacienti se SCID na podkladě CD3 epsilon deficience a atypického kompletního DiGeorgova syndromu a dalších 17 pacientů s jinými vrozenými poruchami imunity, z toho 9 s agamaglobulinemií. U dvou pacientů se SCID umožnil screening časnou kauzální terapii, tj. transplantaci hematopoetických buněk / thymu, u non-SCID pacientů vedla časná znalost jejich diagnózy k zavedení adekvátních režimových a profylaktických opatření za účelem snížení jejich následné morbidity. Od 1. ledna 2024 byl screening závažných vrozených poruch imunity spolu se spinální muskulární atrofií integrován do celoplošného novorozeneckého laboratorního screeningu.

Severe Combined Immunodeficiency (SCID) screening is a collective term for an early detection tool for a range of serious inborn errors of immunity. The quantification of excision DNA molecules TREC and KREC allows for early diagnosis of severe cellular and antibody immune defects. The recently concluded Czech pilot screening program (2022-2023) included over 90% of newborns (with 198,675 samples examined). Two patients with SCID were diagnosed based on CD3 epsilon deficiency and atypical complete DiGeorge syndrome, and another 17 patients were found to have other inborn errors of immunity, including 9 agammaglobulinemia. Screening enabled early causal therapy, i.e., hematopoietic cell/thymus transplantation, for two SCID patients, while early diagnosis in non-SCID patients led to the implementation of appropriate regimen and prophylactic measures to reduce subsequent morbidity. As of January 1, 2024, screening for severe inborn errors of immunity, along with screening for spinal muscular atrophy, becomes integral part of the national laboratory newborn screening program.

• MeSH
• Agammaglobulinemia diagnosis   drug therapy   genetics   MeSH
• Infant MeSH
• Combined Antibody Therapeutics therapeutic use   MeSH
• Humans MeSH
• Neonatal Screening MeSH
• Child, Preschool MeSH
• Primary Immunodeficiency Diseases * diagnosis   genetics   therapy   MeSH
• Severe Combined Immunodeficiency diagnosis   genetics   therapy   MeSH
• Thymus Gland abnormalities   pathology   MeSH
• Hematopoietic Stem Cell Transplantation methods   MeSH
• Organ Transplantation MeSH
• Check Tag
• Infant MeSH
• Humans MeSH
• Male MeSH
• Child, Preschool MeSH
• Publication type
• Case Reports MeSH

Wiskott-Aldrich syndrome (WAS) is a multifaceted monogenic disorder with a broad disease spectrum and variable disease severity and a variety of treatment options including allogeneic hematopoietic stem cell transplantation (HSCT) and gene therapy (GT). No reliable biomarker exists to predict disease course and outcome for individual patients. A total of 577 patients with a WAS variant from 26 countries and a median follow-up of 8.9 years (range, 0.3-71.1), totaling 6118 patient-years, were included in this international retrospective study. Overall survival (OS) of the cohort (censored at HSCT or GT) was 82% (95% confidence interval, 78-87) at age 15 years and 70% (61-80) at 30 years. The type of variant was predictive of outcome: patients with a missense variant in exons 1 or 2 or with the intronic hot spot variant c.559+5G>A (class I variants) had a 15-year OS of 93% (89-98) and a 30-year OS of 91% (86-97), compared with 71% (62-81) and 48% (34-68) in patients with any other variant (class II; P < .0001). The cumulative incidence rates of disease-related complications such as severe bleeding (P = .007), life-threatening infection (P < .0001), and autoimmunity (P = .004) occurred significantly later in patients with a class I variant. The cumulative incidence of malignancy (P = .6) was not different between classes I and II. It confirms the spectrum of disease severity and quantifies the risk for specific disease-related complications. The class of the variant is a biomarker to predict the outcome for patients with WAS.

• MeSH
• Biomarkers MeSH
• Child MeSH
• Adult MeSH
• Genotype * MeSH
• Infant MeSH
• Middle Aged MeSH
• Humans MeSH
• Survival Rate MeSH
• Adolescent MeSH
• Young Adult MeSH
• Follow-Up Studies MeSH
• Child, Preschool MeSH
• Prognosis MeSH
• Wiskott-Aldrich Syndrome Protein genetics   MeSH
• Retrospective Studies MeSH
• Severity of Illness Index MeSH
• Hematopoietic Stem Cell Transplantation MeSH
• Wiskott-Aldrich Syndrome * genetics   diagnosis   therapy   MeSH
• Check Tag
• Child MeSH
• Adult MeSH
• Infant MeSH
• Middle Aged MeSH
• Humans MeSH
• Adolescent MeSH
• Young Adult MeSH
• Male MeSH
• Child, Preschool MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Multicenter Study MeSH

Primary hemophagocytic lymphohistiocytosis (pHLH) is a life-threatening hyperinflammatory syndrome that develops mainly in patients with genetic disorders of lymphocyte cytotoxicity and X-linked lymphoproliferative syndromes. Previous studies with etoposide-based treatment followed by hematopoetic stem cell transplantation (HSCT) resulted in 5-year survival of 50% to 59%. Contemporary data are lacking. We evaluated 88 patients with pHLH documented in the international HLH registry from 2016-2021. In 12 of 88 patients, diagnosis was made without HLH activity, based on siblings or albinism. Major HLH-directed drugs (etoposide, antithymocyte globulin, alemtuzumab, emapalumab, ruxolitinib) were administered to 66 of 76 patients who were symptomatic (86% first-line etoposide); 16 of 57 patients treated with etoposide and 3 of 9 with other first-line treatment received salvage therapy. HSCT was performed in 75 patients; 7 patients died before HSCT. Three-year probability of survival (pSU) was 82% (confidence interval [CI], 72%-88%) for the entire cohort and 77% (CI, 64%-86%) for patients receiving first-line etoposide. Compared with the HLH-2004 study, both pre-HSCT and post-HSCT survival of patients receiving first-line etoposide improved, 83% to 91% and 70% to 88%. Differences to HLH-2004 included preferential use of reduced-toxicity conditioning and reduced time from diagnosis to HSCT (from 148 to 88 days). Three-year pSU was lower with haploidentical (4 of 9 patients [44%]) than with other donors (62 of 66 [94%]; P < .001). Importantly, early HSCT for patients who were asymptomatic resulted in 100% survival, emphasizing the potential benefit of newborn screening. This contemporary standard-of-care study of patients with pHLH reveals that first-line etoposide-based therapy is better than previously reported, providing a benchmark for novel treatment regimes.

• MeSH
• Etoposide therapeutic use   MeSH
• Humans MeSH
• Lymphohistiocytosis, Hemophagocytic * drug therapy   diagnosis   MeSH
• Lymphoproliferative Disorders * etiology   MeSH
• Infant, Newborn MeSH
• Hematopoietic Stem Cell Transplantation * methods   MeSH
• Treatment Outcome MeSH
• Check Tag
• Humans MeSH
• Infant, Newborn MeSH
• Publication type
• Journal Article MeSH

BACKGROUND: Hematopoietic stem cell transplantation (HSCT) represents a curative treatment for patients with severe combined immunodeficiency (SCID), a group of monogenic immune disorders with an otherwise fatal outcome. OBJECTIVE: We performed a comprehensive multicenter analysis of genotype-specific HSCT outcome, including detailed analysis of immune reconstitution (IR) and the predictive value for clinical outcome. METHODS: HSCT outcome was studied in 338 patients with genetically confirmed SCID who underwent transplantation in 2006-2014 and who were registered in the SCETIDE registry. In a representative subgroup of 152 patients, data on IR and long-term clinical outcome were analyzed. RESULTS: Two-year OS was similar with matched family and unrelated donors and better than mismatched donor HSCT (P < .001). The 2-year event-free survival (EFS) was similar in matched and mismatched unrelated donor and less favorable in mismatched related donor (MMRD) HSCT (P < .001). Genetic subgroups did not differ in 2-year OS (P = .1) and EFS (P = .073). In multivariate analysis, pretransplantation infections and use of MMRDs were associated with less favorable OS and EFS. With a median follow-up of 6.2 years (range, 2.0-11.8 years), 73 of 152 patients in the IR cohort were alive and well without Ig dependency. IL-2 receptor gamma chain/Janus kinase 3/IL-7 receptor-deficient SCID, myeloablative conditioning, matched donor HSCT, and naive CD4 T lymphocytes >0.5 × 10e3/μL at +1 year were identified as independent predictors of favorable clinical and immunologic outcome. CONCLUSION: Recent advances in HSCT in SCID patients have resulted in improved OS and EFS in all genotypes and donor types. To achieve a favorable long-term outcome, treatment strategies should aim for optimal naive CD4 T lymphocyte regeneration.

• MeSH
• Cohort Studies MeSH
• Humans MeSH
• Unrelated Donors MeSH
• Transplantation Conditioning methods   MeSH
• Severe Combined Immunodeficiency * genetics   therapy   MeSH
• Hematopoietic Stem Cell Transplantation * methods   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH
• Multicenter Study MeSH
• Research Support, Non-U.S. Gov't MeSH

Cíl studie: Zhodnocení výsledků transplantace kmenových buněk krvetvorby (HSCT, hematopoietic stem cell transplantation) u dětí s dědičnými metabolickými poruchami (DMP) a maligní infantilní osteopetrózou (MIOP) v České republice od začátku transplantačního programu v roce 1989 do současnosti. Metody: V období 1/1993 až 12/2021 bylo ve FN v Motole provedeno celkem 31 alogenních HSCT u 22 pacientů s DMP a 5 pacientů s MIOP. Dárcem kmenových buněk byl HLA identický sourozenec (MSD, matched sibling donor), nepříbuzný dárce (MUD, matched unrelated donor) nebo haploidentický rodinný dárce (MMFD, mismatched family donor). Zdrojem kmenových buněk byla kostní dřeň (KD), periferní kmenové buňky (PBSC, peripheral blood stem cells) nebo pupečníková krev (UCB, umbilical cord blood). Předtransplantační přípravný režim byl použit v souladu s doporučením IEWP-EBMT (Evropská pracovní skupina pro transplantace vrozených onemocnění). Výsledky: 1. alogenní HSCT podstoupilo 22 pacientů s DMP a 5 pacientů s MIOP. Medián věku v době HSCT byl 19,5 měsíce. Primární přihojení štěpu po 1. transplantaci bylo dokumentováno u 24 z 27 pacientů (89 %). U 3 pacientů byla z důvodu nepřihojení či odhojení štěpu nutná retransplantace. Akutní reakce štěpu proti hostiteli (GVHD) byla dokumentována u 11 pacientů (41 %), těžkou formu gr. III vyvinul pouze 1 pacient, chronickou GVHD 1 pacient. Zemřelo celkem 6 pacientů, 3 na komplikace spojené s transplantací, 2 na progresi základního onemocnění, 1 pacient po úspěšné transplantaci na komplikace neurochirurgického výkonu. Celkové přežití je 78 %, 21 z 27 pacientů žije s mediánem doby sledování 169 měsíců po transplantaci (12–347 měsíců), 20 pacientů se zlepšením/stabilizací projevů onemocnění. Závěry: HSCT je v současné době standardní léčebnou metodou u vybraných DMP a MIOP. Naděje na úspěch transplantace vysoce převyšuje její rizika, zásadní je časně stanovená diagnóza a indikace k HSCT. Léčba pacientů vyžaduje komplexní přístup a spolupráci lékařů transplantačního a metabolického centra a dalších specialistů.

Objective: Evaluation of the results of hematopoietic stem cell transplantation (HSCT) in children with inborn errors of metabolism (IEM) and malignant infantile osteopetrosis (MIOP) in the Czech Republic from the beginning of the transplant programme in 1989 to the present. Methods: In the period 1/1993 to 12/2021 a total of 31 allogeneic HSCTs were performed at the University Hospital Motol in 22 patients with IEM and 5 patients with MIOP. Patients were transplanted from HLA identical sibling (MSD), matched unrelated donor (MUD) or mismatched family donor (MMFD). The source of stem cells was bone marrow (BM), peripheral blood stem cells (PBSC) or umbilical cord blood (UCB). The conditioning regimen was used in accordance with the IEWP-EBMT (Inborn Errors Working party – European Bone Marrow Transplant). Results: 22 patients with IEM and 5 patients with MIOP underwent the first allogeneic HSCT at the median age of 19,5 months. Engraftment after the first transplant was documented in 24 of 27 patients (89 %). Three patients underwent retransplantation for primary or secondary graft failure. Acute graft-versus-host disease (GVHD) was documented in 11 patients (41 %), severe form of aGVHD gr. III in 1 patient and chronic GVHD in 1 patient, respectively. A total of 6 patients died, 3 patients due to transplant-related mortality, 2 patients from disease progression, respectively and 1 patient died after a successful transplant due to complications of neurosurgery. The overall survival is 78 %, 21 of 27 patients are alive with a median follow-up of 169 months after transplantation (12-347 months), 20 of them with improvement or stabilization of the disease. Conclusions: HSCT is currently the standard therapy for selected IEM and MIOP. This procedure has become much safer during recent decades, timely diagnosis and indication for HSCT are essential. The treatment requires multidisciplinary management and continuous collaboration with other specialists.

• Keywords
• maligní infantilní osteopetróza,
• MeSH
• Adrenoleukodystrophy therapy   MeSH
• Child MeSH
• Humans MeSH
• Mucopolysaccharidoses therapy   MeSH
• Hematopoietic Stem Cell Transplantation * methods   MeSH
• Metabolism, Inborn Errors * therapy   MeSH
• Check Tag
• Child MeSH
• Humans MeSH

Data on stem cell transplantation (SCT) for Diamond-Blackfan Anemia (DBA) is limited. We studied patients transplanted for DBA and registered in the EBMT database. Between 1985 and 2016, 106 DBA patients (median age, 6.8 years) underwent hematopoietic stem cell transplantation from matched-sibling donors (57%), unrelated donors (36%), or other related donors (7%), using marrow (68%), peripheral blood stem cells (20%), both marrow and peripheral blood stem cells (1%), or cord blood (11%). The cumulative incidence of engraftment was 86% (80% to 93%), and neutrophil recovery and platelet recovery were achieved on day +18 (range, 16 to 20) and +36 (range, 32 to 43), respectively. Three-year overall survival and event-free survival were 84% (77% to 91%) and 81% (74% to 89%), respectively. Older patients were significantly more likely to die (hazard ratio, 1.4; 95% confidence interval, 1.06 to 1.23; P < .001). Outcomes were similar between sibling compared to unrelated-donor transplants. The incidence of acute grades II to IV of graft-versus-host disease (GVHD) was 30% (21% to 39%), and the incidence of extensive chronic GVHD was 15% (7% to 22%). This study shows that SCT may represent an alternative therapeutic option for transfusion-dependent younger patients.

• MeSH
• Anemia, Aplastic * therapy   MeSH
• Anemia, Diamond-Blackfan * therapy   MeSH
• Child MeSH
• Bone Marrow MeSH
• Humans MeSH
• Retrospective Studies MeSH
• Hematopoietic Stem Cell Transplantation * MeSH
• Check Tag
• Child MeSH
• Humans MeSH
• Publication type
• Journal Article MeSH

Cíl studie: Použití léčebného ozáření a vysokodávkované chemoterapie je spojeno s rizikem časných i pozdních komplikací. Postižení štítné žlázy je známým problémem doprovázejícím alogenní transplantaci kmenových buněk krvetvorby (HSCT – hematopoietic stem cell transplantation). Cílem této práce je zhodnotit výskyt a projevy postižení štítné žlázy u pacientů, kteří v našem centru podstoupili alogenní transplantaci v dětském věku a adolescenci (Transplantační jednotka kostní dřeně, Klinika dětské hematologie a onkologie, Fakultní nemocnice Motol, Praha). Pacienti a metody: Jedná se o retrospektivní analýzu dat pacientů, kteří podstoupili HSCT v dětském věku a v adolescenci a následně u nich bylo diagnostikováno postižení štítné žlázy. Funkci štítné žlázy jsme hodnotili klinicky a laboratorně v době před transplantací, šest měsíců a každý rok po transplantaci. Sonografické vyšetření bylo prováděno u pacientů s prokázanou tyreopatií a preventivně pak v delším časovém odstupu po transplantaci (více než pět let, zejména u skupiny ozářených pacientů). Zhodnotili jsme data 463 pacientů (295 mužů, 168 žen), transplantovaných v mediánu věku 7,8 roku (rozmezí 0,1–20,5) v letech 1989 až 2018. V době hodnocení přežíval každý z nich nejméně jeden rok po transplantaci. Pro maligní onemocnění bylo léčeno 301 pacientů (65 %). Jedna třetina pacientů měla jako součást předtransplantační přípravy celotělové ozáření (CTO), přípravný režim zahrnující použití Busulfanu byl uplatněn u téměř 50 % pacientů. Nepříbuzného dárce mělo 327 pacientů, u 33,4 % byl dárcem shodný sourozenec nebo jiný rodinný dárce. Výsledky: Postižení štítné žlázy bylo diagnostikováno u 169 pacientů (36,5 % z celkového počtu) v mediánu dva roky (rozmezí: 0,4–21,3 roku) po HSCT. Primární hypotyreóza byla nejčastějším postižením (110 pacientů, 65,1 %), klinické příznaky mělo pouze devět pacientů. Zvýšené hladiny autoprotilátek (aTPO, aTG) byly detekovány u 95 pacientů. Uzly štítné žlázy byly v rámci ultrazvukového vyšetření nalezeny u 28 pacientů, v mediánu 11,5 roku (5,1–23,4) po transplantaci, 14 se již léčilo pro poruchu funkce štítné žlázy (hypotyreóza = 8, autoimunitní onemocnění štítné žlázy – AITD = 6). U osmi pacientů (1,7 % z celkového počtu, 28,5 % pacientů s uzlem) byl diagnostikován karcinom štítné žlázy v mediánu 10,8 roku (rozmezí 5,4–21,5 let) po transplantaci, sedm pacientů z osmi mělo přípravný režim s CTO. Závěry: Alogenní transplantace kmenových buněk krvetvorby je léčebnou modalitou pro řadu maligních i nemaligních onemocnění. Se stále se zlepšujícími výsledky léčby je nyní pozornost věnována také oblasti pozdních následků léčby u dlouhodobě přežívajících pacientů. Postižení štítné žlázy je jednou z nejčastějších komplikací. Je proto nezbytné pravidelně (po 6–12 měsících) kontrolovat a vyšetřovat funkci štítné žlázy klinicky a zejména laboratorními parametry. Riziko sekundárních malignit těchto pacientů roste v čase. Pečlivé sledování zahrnující ultrazvukové vyšetření (za 1–3 roky) je velmi důležité pro časnou detekci nádorů, zejména u pacientů po celotělovém záření.

Radiotherapy and high-dose chemotherapy can cause a lot of early and late effects. Thyroid dysfunction is a known late complication following HSCT (hematopoietic stem cell transplantation). The objective of this study was to analyze the occurrence and characteristics of thyroid dysfunction in patients who have undergone HSCT in childhood and adolescence at our center (HSCT Unit, Department of Pediatric Hematology and Oncology, University Hospital Motol, Prague). Patients and methods: A retrospective review of clinical records was conducted for patients who had undergone allogeneic HSCT in childhood and adolescence, and subsequently were diagnosed with thyroid involvement. Thyroid gland function was evaluated in regular terms (pre-HSCT, six months, one year and then annually after HSCT). Ultrasound examination was performed in patients with thyroid gland involvement and as a screening. We have evaluated data in 463 patients (295 male, 168 female) who underwent allogeneic transplantation at a median age of 7.8 years (range: 0.1–20.5) from 1989 till 2018 and were alive more than one year after transplantation at the time of evaluation. Three hundred one patient (65%) were treated for malignant disease. In one‑third of patients who underwent HSCT, total body irradiation (TBI) conditioning regimen was used, almost 50% of patients underwent Busulphan based condition regimen. Three hundred twenty-seven transplantations (66.6%) were performed from an unrelated donor, 33.4% from a matched sibling or other family donor. Results: One hundred sixty-nine patients (36.5%) were diagnosed with thyroid gland involvement at a median of 2.0 (range: 0.4–21.3) years after HSCT. Primary hypothyroidism was the most common type of thyroid dysfunction (110 patients – 65.1%), only nine of them were with clinical signs. Thyroid anti-bodies (aTPO, aTG) were detected in 95 patients. Thyroid nodules were found during ultrasound examination in 29 patients at a median of 11.5 (range 5.1–23.4) years after HSCT, fifteen patients were treated due to thyroid dysfunction (hypo = 8, AITD = 7). Thyroid carcinoma was diagnosed in 8 patients (in 1.7% of all patients, 27.6% of patients with nodules) at a median of 10.8 (range 5.4–21.5) years after HSCT. All but one had received TBI based conditioning regimen. Conclusions: Allogeneic hematopoietic stem cell transplantation is a potentially curative therapy for a variety of malignant and non-malignant disorders. With the improved outcome, increasing attention has been drawn to late complications in long-term survivors. Thyroid dysfunction is one of the most frequent complications. Regular evaluation of thyroid gland function (every 6–12 months) including laboratory parameters is highly recommended. The risk of secondary malignancies after HSCT is increasing within time. Careful follow-up of thyroid status including annual ultrasound examination every 1–3 years, is very important for early detection of tumor, namely in all patients exposed to TBI.

• MeSH
• Child MeSH
• Adult MeSH
• Transplantation, Homologous MeSH
• Humans MeSH
• Adolescent MeSH
• Thyroid Diseases * chemically induced   diagnosis   therapy   MeSH
• Postoperative Complications MeSH
• Retrospective Studies MeSH
• Bone Marrow Transplantation * adverse effects   MeSH
• Check Tag
• Child MeSH
• Adult MeSH
• Humans MeSH
• Adolescent MeSH
• Male MeSH
• Female MeSH
• Publication type
• Research Support, Non-U.S. Gov't MeSH

• Publication type
• Meeting Abstract MeSH