Ovarian function in female survivors of high-risk neuroblastoma Journal Article
| Authors: | Jimenez-Kurlander, L.; DeRosa, A.; Kostrzewa, C. E.; Moskowitz, C. S.; Bogardus, K.; Antal, Z.; Wolden, S.; La Quaglia, M. P.; Basu, E. M.; Cardenas, F. I.; Kramer, K.; Kushner, B. H.; Cheung, N. K. V.; Modak, S.; Friedman, D. N. |
| Article Title: | Ovarian function in female survivors of high-risk neuroblastoma |
| Abstract: | Introduction: Data on ovarian function in neuroblastoma survivors are limited. We sought to determine the prevalence of ovarian dysfunction in a cohort of high-risk neuroblastoma survivors and compare outcomes among survivors treated with and without autologous stem cell rescue (ASCR) preceded by myeloablative chemotherapy. Methods: Retrospective review of female survivors of high-risk neuroblastoma ≥5 years from diagnosis, diagnosed between 1982 and 2014, and followed in a tertiary cancer center. Participants were divided into two groups: individuals treated with conventional chemotherapy ± radiation (“non-ASCR”) (n = 32) or with chemotherapy ± radiation followed by myeloablative chemotherapy with ASCR (“ASCR”) (n = 51). Ovarian dysfunction was defined as follicle-stimulating hormone ≥15 mU/mL, while premature ovarian insufficiency (POI) was defined as persistent ovarian dysfunction requiring hormone replacement therapy. Poisson models were used to determine prevalence ratios of ovarian dysfunction and POI. Results: Among 83 females (median attained age: 19 years [range, 10-36]; median follow-up: 15 years [range, 7-36]), 49 (59%) had ovarian dysfunction, and 34 (41%) developed POI. Survivors treated with ASCR were 3.2-fold more likely to develop ovarian dysfunction (95% CI: 1.8-6.0; p < 0.001) and 4.5-fold more likely to develop POI (95% CI: 1.7-11.7; p = 0.002) when compared with those treated with conventional chemotherapy, after adjusting for attained age. Two participants in the non-ASCR group and six in the ASCR group achieved at least one spontaneous pregnancy. Discussion: Ovarian dysfunction is prevalent in female high-risk neuroblastoma survivors, especially after ASCR. Longitudinal follow-up of larger cohorts is needed to inform counseling about the risk of impaired ovarian function after neuroblastoma therapy. © 2024 Wiley Periodicals LLC. |
| Keywords: | neuroblastoma; childhood cancer survivors; fertility preservation; ovarian function; autologous hematopoietic stem cell rescue |
| Journal Title: | Pediatric Blood and Cancer |
| Volume: | 71 |
| Issue: | 9 |
| ISSN: | 1545-5009 |
| Publisher: | Wiley Periodicals, Inc |
| Date Published: | 2024-09-01 |
| Start Page: | e31181 |
| Language: | English |
| DOI: | 10.1002/pbc.31181 |
| PUBMED: | 38967225 |
| PROVIDER: | scopus |
| PMCID: | PMC11269001 |
| DOI/URL: | |
| Notes: | The MSK Cancer Center Support Grant (P30 CA008748) is acknowledge in the PDF -- Source: Scopus |
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