TY - JOUR
T1 - Acute onset of ovarian dysfunction in young females after start of cancer treatment
AU - Mörse, Helena
AU - Elfving, Maria
AU - Lindgren, Anna
AU - Wölner-Hanssen, Pål
AU - Andersen, Claus Yding
AU - Øra, Ingrid
PY - 2013/4
Y1 - 2013/4
N2 - Background: Female childhood cancer survivors are at risk of ovarian failure and premature ovarian insufficiency. We hereby present an interim analysis of a prospective observational study of ovarian function during cancer treatment of young females in relation to clinical factors. Procedure: Thirty-four consecutive female cancer patients aged 0-18 year were included after informed consent. Serum/Plasma levels of anti-Müllerian hormone (AMH), inhibin B, FSH, LH, and oestradiol (E2) were measured at diagnosis and every 3-4 months during and after treatment. Results: All patients had detectable AMH levels at diagnosis. Eleven patients had reached menarche (mean age 141/2 years) and the remaining patients had a mean age of 61/2 years. They all showed a rapid decline in AMH after 3 months of treatment, regardless of AMH at diagnosis, age, menarche, or treatment given. Those given radiotherapy below the diaphragm and/or stem cell transplantation (SCT) (n=9) had no ovarian recovery during or 11/2-year after treatment. However, recovery was observed in those given standard treatment for acute lymphatic leukemia (n=7) already during maintenance chemotherapy. For the remaining patients, longer follow-up is required for analysis of ovarian recovery after treatment. Conclusions: Rapid ovarian dysfunction is observed in all females after initiation of cancer treatment as measured by AMH and inhibin B. Our data regarding those who require abdominal radiotherapy and/or SCT confirms the recommendations in the Nordic countries where these patients are eligible for cryopreservation of ovarian cortical tissue before start of cancer treatment.
AB - Background: Female childhood cancer survivors are at risk of ovarian failure and premature ovarian insufficiency. We hereby present an interim analysis of a prospective observational study of ovarian function during cancer treatment of young females in relation to clinical factors. Procedure: Thirty-four consecutive female cancer patients aged 0-18 year were included after informed consent. Serum/Plasma levels of anti-Müllerian hormone (AMH), inhibin B, FSH, LH, and oestradiol (E2) were measured at diagnosis and every 3-4 months during and after treatment. Results: All patients had detectable AMH levels at diagnosis. Eleven patients had reached menarche (mean age 141/2 years) and the remaining patients had a mean age of 61/2 years. They all showed a rapid decline in AMH after 3 months of treatment, regardless of AMH at diagnosis, age, menarche, or treatment given. Those given radiotherapy below the diaphragm and/or stem cell transplantation (SCT) (n=9) had no ovarian recovery during or 11/2-year after treatment. However, recovery was observed in those given standard treatment for acute lymphatic leukemia (n=7) already during maintenance chemotherapy. For the remaining patients, longer follow-up is required for analysis of ovarian recovery after treatment. Conclusions: Rapid ovarian dysfunction is observed in all females after initiation of cancer treatment as measured by AMH and inhibin B. Our data regarding those who require abdominal radiotherapy and/or SCT confirms the recommendations in the Nordic countries where these patients are eligible for cryopreservation of ovarian cortical tissue before start of cancer treatment.
U2 - 10.1002/pbc.24327
DO - 10.1002/pbc.24327
M3 - Journal article
C2 - 23015461
SN - 1545-5009
VL - 60
SP - 676
EP - 681
JO - Pediatric Blood and Cancer
JF - Pediatric Blood and Cancer
IS - 4
ER -
