Premature Menopause in Survivors of Childhood Cancer: A Report From the Childhood Cancer Survivor Study

Sklar, Charles A.; Mertens, Ann C.; Mitby, Pauline; Whitton, John; Stovall, Marilyn; Kasper, Catherine E.; Mulder, Jean E.; Green, Daniel; Nicholson, H. Stacy; Yasui, Yutaka; Robison, Leslie L.

doi:10.1093/jnci/djj243

Cited by 491 publications

(351 citation statements)

References 32 publications

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“…This difference may suggest a possible prolongation of the "fertility window" by 7 years (or more) using GnRH agonist adjuvant cotreatment in parallel with chemotherapy. This is in keeping with the experience reported by others [32,33] who also found the median age of pregnant survivors of lymphomas to be 18 years (range, [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28], with only few reported pregnancies for female patients Ͼ30 years old.…”

Section: Gnrh Agonist Treatment In Cancer Patientssupporting

confidence: 89%

“…Similarly, Sklar et al, [21] recently found that survivors of childhood cancer have an 8% risk of suffering POF before the age of 40, compared with Ͻ1% in the general population. This is in keeping with our and others' results whereby women of reproductive age receiving a GnRH agonist in addition to chemotherapy suffer POF in about 7%-10% of cases (simulating prepubertal exposure), whereas those treated without the agonist have about a 40% risk for POF [1-7, 10,11,14,16 -19, 22, 23] .…”

Section: Gnrh Agonist Treatment In Cancer Patientsmentioning

confidence: 82%

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How to Preserve Fertility in Young Women Exposed to Chemotherapy? The Role of GnRH Agonist Cotreatment in Addition to Cryopreservation of Embrya, Oocytes, or Ovaries

Blumenfeld¹

2007

The Oncologist

243

177

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After completing this course, the reader will be able to:1. Discuss the possibilities for preserving fertility in women exposed to chemotherapy.2. List the possible mechanisms put forward to explain the beneficial effect of GnRH agonists in minimizing the gonadotoxic effect of chemotherapy, in particular that of alkylating agents.3. Identify the advantages and possible risks and shortcomings of each of the proposed methods for fertility preservation in women exposed to gonadotoxic chemotherapy.4. Discuss the possibility of combining several methods to maximize the chances of fertility preservation in these patients.5. Explain the gender differences between male and female patients regarding the methods of fertility preservation.Access and take the CME test online and receive 1 AMA PRA Category 1 Credit ™ at CME.TheOncologist.com CME CME ABSTRACTThe possibilities to preserve fertility in women exposed to chemotherapy are: in vitro fertilization plus embryo cryopreservation, ovarian cryopreservation, unfertilized ova cryopreservation, and the administration of a gonadotropin-releasing hormone (GnRH) agonist. Because none of these methods is ideal, combination of several methods should be considered. Because the chances of preserving gonadal function following combinedmodality treatment are significantly better for girls than for boys, simulation of a prepubertal milieu was applied only to women of reproductive age.

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Section: Gnrh Agonist Treatment In Cancer Patientssupporting

confidence: 89%

Section: Gnrh Agonist Treatment In Cancer Patientsmentioning

confidence: 82%

How to Preserve Fertility in Young Women Exposed to Chemotherapy? The Role of GnRH Agonist Cotreatment in Addition to Cryopreservation of Embrya, Oocytes, or Ovaries

Blumenfeld¹

2007

The Oncologist

243

177

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“…As the average age within the study group at diagnosis was 52.7 years, only a minor fraction developed acute or premature ovarian failure as frequently described after childhood cancer treatment (44). Due to this composition of our study group a systematic analysis of potential deficiencies in female sex hormones and their functional implications was not performed.…”

Section: Clinical Study J Gebauer E-m Fick and Others Endocrine Latementioning

confidence: 99%

Self-reported endocrine late effects in adults treated for brain tumours, Hodgkin and non-Hodgkin lymphoma: a registry based study in Northern Germany

Gebauer

Fick

Waldmann

et al. 2015

European Journal of Endocrinology

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Objective: Due to the increasing success and survival rates in the primary treatment of malignancies derived from the CNS as well as the hematopoietic system, endocrine late effects of cancer and its therapy are of growing importance. Despite evaluation of these late effects in patients treated for cancer in childhood, the impact on adults remains largely unclear. Methods: 1035 adult patients primarily diagnosed with a CNS malignancy, a Hodgkin (HL) or non-Hodgkin lymphoma (NHL) between 1998 and 2008 were recruited via the regional epidemiological cancer registry covering w2.8 million inhabitants in the federal state of Schleswig-Holstein, Northern Germany. The prevalence of endocrine disorders and current psychosocial impairment was assessed employing several questionnaires (SF-36v1, WHO-5). Results: Fully completed questionnaires of 558 patients were available for subsequent analysis showing markedly reduced overall performance and psychological status when compared to German reference data. Thyroid disorders were reported in 16.3% of patients with 10.4% suffering from hypo-and 5.9% from hyperthyroidism. Overall, 17.6% stated to be affected by diabetes mellitus with an increased rate of 21.1% among NHL patients and 11.5% of participants were affected by osteoporosis. Conclusion: Compared to German population based studies on the prevalence of diabetes mellitus, osteoporosis and thyroid disorders the frequency of all these endocrine problems was significantly increased in CNS, HL, and NHL cancer survivors. These data confirm that not only children and adolescents but also adult cancer patients are at risk for therapy associated endocrine late effects.

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“…1 Although rare in most populations, HL is a relatively common cancer of adolescents and young adults, and treatment-related sequelae remain a serious life-long problem. [2][3][4][5] Thus, understanding HL etiology is a worthwhile research endeavor with the goal of primary prevention. Numerous epidemiologic studies have identified a variety of putative risk factors as well as substantial etiologic heterogeneity based on age group at diagnosis, tumor histologic subtype, and the presence or absence of Epstein-Barr virus (EBV) in the malignant Hodgkin/Reed-Sternberg cells.…”

Section: Introductionmentioning

confidence: 99%

Exposure to UV radiation and risk of Hodgkin lymphoma: a pooled analysis

Monnereau

Glaser

Schupp

et al. 2013

Blood

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• Our pooled analysis found an inverse association between several measures of UVR exposure and Hodgkin lymphoma. • Significant UVR-related inverse associations of EBV-positive HL with a doseresponse relationship support etiologic heterogeneity in HL.Ultraviolet radiation (UVR) exposure has been inversely associated with Hodgkin lymphoma (HL) risk, but only inconsistently, only in a few studies, and without attention to HL heterogeneity. We conducted a pooled analysis of HL risk focusing on type and timing of UVR exposure and on disease subtypes by age, histology, and tumor-cell Epstein-Barr virus (EBV) status. Four case-control studies contributed 1320 HL cases and 6381 controls. We estimated lifetime, adulthood, and childhood UVR exposure and history of sunburn and sunlamp use. We used 2-stage estimation with mixed-effects models and weighted pooled effect estimates by inverse marginal variances. We observed statistically significant inverse associations with HL risk for UVR exposures during childhood and adulthood, sunburn history, and sunlamp use, but we found no significant doseresponse relationships. Risks were significant only for EBV-positive HL (pooled odds ratio, 0.56; 95% confidence interval, 0.35 to 0.91 for the highest overall UVR exposure category), with a significant linear trend for overall exposure (P 5 .03). Pooled relative risk estimates were not heterogeneous across studies. Increased UVR exposure may protect against HL, particularly EBV-positive HL. Plausible mechanisms involving UVR induction of regulatory T cells or the cellular DNA damage response suggest opportunities for new prevention targets. (Blood. 2013;122(20):3492-3499)

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Premature Menopause in Survivors of Childhood Cancer: A Report From the Childhood Cancer Survivor Study

Abstract: The results of this study will facilitate counseling current survivors about their future risk of premature menopause and aid in designing new regimens that seek to diminish late ovarian toxicity.

Cited by 491 publications

References 32 publications

How to Preserve Fertility in Young Women Exposed to Chemotherapy? The Role of GnRH Agonist Cotreatment in Addition to Cryopreservation of Embrya, Oocytes, or Ovaries

How to Preserve Fertility in Young Women Exposed to Chemotherapy? The Role of GnRH Agonist Cotreatment in Addition to Cryopreservation of Embrya, Oocytes, or Ovaries

Self-reported endocrine late effects in adults treated for brain tumours, Hodgkin and non-Hodgkin lymphoma: a registry based study in Northern Germany

Exposure to UV radiation and risk of Hodgkin lymphoma: a pooled analysis

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