TY - JOUR
T1 - Pubertal development and fertility in survivors of childhood acute myeloid leukemia treated with chemotherapy only
T2 - A NOPHO-AML study
AU - Molgaard-Hansen, Lene
AU - Skou, Anne-Sofie
AU - Juul, Anders
AU - Glosli, Heidi
AU - Jahnukainen, Kirsi
AU - Jarfelt, Marianne
AU - Jónmundsson, Guðmundur K
AU - Malmros, Johan
AU - Nysom, Karsten
AU - Hasle, Henrik
AU - Hematology, Nordic Society of Pediatric
AU - (NOPHO), Oncology
PY - 2013/12
Y1 - 2013/12
N2 - Background: More than 60% of children with acute myeloid leukemia (AML) become long-term survivors. Most are cured using chemotherapy without hematopoietic stem cell transplantation (HSCT). We report on pubertal development and compare self-reported parenthood among AML survivors and their siblings. Procedure: We included 137 children treated for AML according to the Nordic Society of Pediatric Hematology and Oncology (NOPHO)-AML-84, -88, and -93 trials, who were alive by June 2007. Patients with relapse or treated with HSCT were excluded. AML survivors participated in a physical and biochemical examination (n=102) and completed a questionnaire (n=101). One of their siblings completed an identical questionnaire (n=84). Results: At a median follow-up of 11 years (range 5-25) after diagnosis of AML the survivors (median age 16 years, range 5-36) were either prepubertal or had entered puberty normally. Serum levels of FSH, LH, testosterone, estradiol, sex hormone binding globulin (SHBG), inhibin A and B, and testicular volumes were within normal ranges. Anti-Müllerian hormone (AMH) levels were decreased in 5 of 40 postpubertal females. Mean reported age at menarche was 13.1 (range 11-17) years. Among survivors 15 years of age or older 31% of females reported pregnancies and 9% of males reported pregnancies in their partners, rates comparable with the frequency reported by their siblings. Conclusions: Most AML survivors treated with chemotherapy had normal pubertal development and fertility, however, AMH levels were decreased in 13% of postpubertal females. Longer follow-up is necessary to evaluate possible risk of premature ovarian failure. Pediatr Blood Cancer 2013;60:1988-1995.
AB - Background: More than 60% of children with acute myeloid leukemia (AML) become long-term survivors. Most are cured using chemotherapy without hematopoietic stem cell transplantation (HSCT). We report on pubertal development and compare self-reported parenthood among AML survivors and their siblings. Procedure: We included 137 children treated for AML according to the Nordic Society of Pediatric Hematology and Oncology (NOPHO)-AML-84, -88, and -93 trials, who were alive by June 2007. Patients with relapse or treated with HSCT were excluded. AML survivors participated in a physical and biochemical examination (n=102) and completed a questionnaire (n=101). One of their siblings completed an identical questionnaire (n=84). Results: At a median follow-up of 11 years (range 5-25) after diagnosis of AML the survivors (median age 16 years, range 5-36) were either prepubertal or had entered puberty normally. Serum levels of FSH, LH, testosterone, estradiol, sex hormone binding globulin (SHBG), inhibin A and B, and testicular volumes were within normal ranges. Anti-Müllerian hormone (AMH) levels were decreased in 5 of 40 postpubertal females. Mean reported age at menarche was 13.1 (range 11-17) years. Among survivors 15 years of age or older 31% of females reported pregnancies and 9% of males reported pregnancies in their partners, rates comparable with the frequency reported by their siblings. Conclusions: Most AML survivors treated with chemotherapy had normal pubertal development and fertility, however, AMH levels were decreased in 13% of postpubertal females. Longer follow-up is necessary to evaluate possible risk of premature ovarian failure. Pediatr Blood Cancer 2013;60:1988-1995.
U2 - 10.1002/pbc.24715
DO - 10.1002/pbc.24715
M3 - Journal article
SN - 1545-5009
VL - 60
SP - 1988
EP - 1995
JO - Pediatric Blood and Cancer
JF - Pediatric Blood and Cancer
IS - 12
ER -
