Gonadal Failure Is Common in Long-Term Survivors of Childhood High-Risk Neuroblastoma Treated With High-Dose Chemotherapy and Autologous Stem Cell Rescue

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Utriainen , P , Suominen , A , Mäkitie , O & Jahnukainen , K 2019 , ' Gonadal Failure Is Common in Long-Term Survivors of Childhood High-Risk Neuroblastoma Treated With High-Dose Chemotherapy and Autologous Stem Cell Rescue ' , Frontiers in Endocrinology , vol. 10 , 555 . https://doi.org/10.3389/fendo.2019.00555

Title: Gonadal Failure Is Common in Long-Term Survivors of Childhood High-Risk Neuroblastoma Treated With High-Dose Chemotherapy and Autologous Stem Cell Rescue
Author: Utriainen, Pauliina; Suominen, Anu; Mäkitie, Outi; Jahnukainen, Kirsi
Contributor: University of Helsinki, Director and Common Matters
University of Helsinki, Children's Hospital
University of Helsinki, Children's Hospital
Date: 2019-08-08
Number of pages: 10
Belongs to series: Frontiers in Endocrinology
ISSN: 1664-2392
URI: http://hdl.handle.net/10138/304585
Abstract: Background: Neuroblastoma is the most common extra-cranial solid tumor in children. Intensive therapy including autologous stem-cell transplantation (HSCT) has improved the poor prognosis of high-risk neuroblastoma (HR-NBL) but may impair gonadal function. Objectives: To investigate the gonadal function and fertility in long-term survivors of childhood HR-NBL. Design: A cohort including all Finnish (n = 20; 11 females) long-term (> 10 years) survivors of HR-NBL and an age-and sex-matched control group (n = 20) was examined at a median age of 22 (16-30) years. Oncologic treatments, pubertal timing, hormonal therapies and the number of off-spring were recorded, and pituitary and gonadal hormones were measured. Results: Altogether 16/20 of the long-term survivors of HR-NBL entered puberty spontaneously; puberty was hormonally induced in four survivors (three females). Among the 8/11 female survivors with spontaneous puberty, seven had spontaneous menarche, but 5/8 developed ovarian failure soon after puberty. Nine females currently needed estrogen substitution. AMH, a marker of ovarian reserve, was lower in the female survivors than controls (median 0.02 vs. 1.7 mu g/l, p <0.001). As a group, male survivors had smaller testicular size (8.5 vs. 39ml, p <0.001) and lower inhibin B ( Conclusion: Gonadal failure is common in long-term survivors of HR-NBL treated with HSCT. Fertility may be preserved in some survivors treated without total-body irradiation.
Subject: 3123 Gynaecology and paediatrics
high-risk neuroblastoma
irradiation
chemotherapy
late effect of cancer treatment
gonadal function
gonadal failure
fertility
puberty
ANTI-MULLERIAN HORMONE
BONE-MARROW
CANCER
CHILDREN
FERTILITY
TRANSPLANTATION
THERAPY
TANDEM
RADIOTHERAPY
ENDOCRINE
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