Powikłania endokrynologiczne i metaboliczne terapii chorób rozrostowych układu krwiotwórczego

Abstract

Despite the significant progress in the treatment of haematological malignancies and the improvement of treatment efficacy, it is still associated with numerous side effects. Among them, endocrinological and diabetic complications of immunotherapy are of particular importance, and they belong to the most frequently observed, mainly due to the interference of the treatment with functioning of the immune system. As a result, it can lead to the induction of autoimmune processes in many systems, including endocrine glands. The effectiveness of some therapies may also be determined by the occurrence of side effects in the form of autoimmune diseases. Increasing use of tyrosine kinase inhibitors, immune checkpoint inhibitors, as well as glucocorticosteroids exerting immunosuppressive effect, which are applied, leads to the development of various pathologies of the endocrine system. The most common complications developing on the background of autoimmune inflammation are disturbances in the function of thyroid gland, pituitary gland in its anterior lobe, and very rarely in the posterior lobe in the form of diabetes insipidus. The above-mentioned disorders may occur in patients of all ages, regardless of gender. Some dysfunctions are subclinical and are found incidentally during routine check-up, both in the course of the treatment process or after its completion. Taking into account the possibility of serious consequences of the therapy, it is now recommended to periodically control the patients.