International Journal of Hematology

, Volume 94, Issue 4, pp 399–402 | Cite as

Empty sella/pituitary atrophy and endocrine impairments as a consequence of radiation and chemotherapy in long-term survivors of childhood leukemia

  • Yoshikazu Nishi
  • Kazuko Hamamoto
  • Naoto Fujita
  • Satoshi Okada
Case Report


Radiation-induced empty sella (ES) or pituitary atrophy/small pituitary and endocrine impairments, including pituitary and gonadal dysfunction, can manifest decades after radiation and chemotherapy in childhood-onset leukemia patients who received prophylactic cranial irradiation or total body irradiation in preparation for bone marrow transplant. Six childhood-onset leukemia patients (age at diagnosis of leukemia; 2.7–10.2 years) participated in this study. Magnetic resonance imaging (MRI) of the pituitary gland and endocrinological studies were performed 10.5–32.1 years after cranial irradiation. In four of the six patients examined, ES or pituitary atrophy was detected approximately 10.5–19.8 years after cranial irradiation. Four patients had hypogonadism (primary, 3; hypothalamic-pituitary, 1) and one had primary hypothyroidism. We conclude that ES or pituitary atrophy and endocrine impairments can manifest decades after radiation and chemotherapy in childhood-onset leukemia. These patients should, therefore, undergo regular follow-up, including pituitary MRI and hormonal examinations.


Childhood-onset leukemia Total body irradiation Cranial irradiation Endocrine impairments Radiation-induced empty sella/pituitary atrophy 


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Copyright information

© The Japanese Society of Hematology 2011

Authors and Affiliations

  • Yoshikazu Nishi
    • 1
  • Kazuko Hamamoto
    • 1
  • Naoto Fujita
    • 1
  • Satoshi Okada
    • 2
  1. 1.Department of PediatricsHiroshima Red Cross HospitalHiroshimaJapan
  2. 2.Department of PediatricsHiroshima University Graduate School of Biomedical SciencesHiroshimaJapan

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