Timing of menarche among survivors of childhood acute lymphoblastic leukemia: A report from the Childhood Cancer Survivor Study Journal Article


Authors: Chow, E. J.; Friedman, D. L.; Yasui, Y.; Whitton, J. A.; Stovall, M.; Robison, L. L.; Sklar, C. A.
Article Title: Timing of menarche among survivors of childhood acute lymphoblastic leukemia: A report from the Childhood Cancer Survivor Study
Abstract: Background. The objective of this study was to determine risk factors associated with abnormal timing of menarche among survivors of childhood acute lymphoblastic leukemia (ALL). Procedure. Self-reported age of menarche was determined among 949 female ALL survivors participating in the Childhood Cancer Survivor Study (CCSS), a cohort of 5-year survivors of common pediatric cancers diagnosed from 1970 to 1986, and compared with 1,1 28 siblings. Results. The majority of survivors (92%) and siblings (97%) reported menarche between the ages of 10 and 16. Survivors treated with chemotherapy alone, including those exposed to alkylating agents, experienced menarche at a similar rate to siblings. However, compared to chemotherapy alone, cranial radiotherapy was associated with early menarche (age < 10; OR 6.2, 95% CI 2.1, 18.5) while craniospinal radiotherapy was associated with both early (OR 8.6, 95% CI 1.9, 38.6) and late (age > 16; OR 4.8, 95% CI 1.4, 16.7) menarche. There were no differences in effect between <20 and ≥20 Gy radiotherapy doses. In multivariable analysis, younger age at diagnosis was an independent risk factor for early menarche. Conclusions. Few female childhood ALL survivors experienced menarche outside of the normal range. Alkylating agent exposure was not associated with abnormal timing. However, those exposed to cranial and craniospinal radiotherapy, especially at a young age, should be monitored closely for abnormal timing of menarche. © 2007 Wiley-Liss, Inc.
Keywords: adolescent; adult; cancer chemotherapy; child; leukemia; major clinical study; cancer radiotherapy; antineoplastic agent; radiation; radiotherapy; risk factors; alkylating agent; cyclophosphamide; age factors; risk factor; carmustine; lomustine; acute lymphoblastic leukemia; puberty; time; late effects; menarche; cancer survivor; self report; dose-response relationship, radiation; survivors; antineoplastic agents, alkylating; precursor cell lymphoblastic leukemia-lymphoma; alkylating agents; childhood leukemia; age of onset
Journal Title: Pediatric Blood and Cancer
Volume: 50
Issue: 4
ISSN: 1545-5009
Publisher: Wiley Periodicals, Inc  
Date Published: 2008-04-01
Start Page: 854
End Page: 858
Language: English
DOI: 10.1002/pbc.21316
PUBMED: 17729247
PROVIDER: scopus
DOI/URL:
Notes: --- - "Cited By (since 1996): 14" - "Export Date: 17 November 2011" - "CODEN: PBCEA" - "Source: Scopus"
Altmetric
Citation Impact
MSK Authors
  1. Charles A Sklar
    299 Sklar