Ovarian function in survivors of childhood medulloblastoma: Impact of reduced dose craniospinal irradiation and high-dose chemotherapy with autologous stem cell rescue Journal Article


Authors: Balachandar, S.; Dunkel, I. J.; Khakoo, Y.; Wolden, S.; Allen, J.; Sklar, C. A.
Article Title: Ovarian function in survivors of childhood medulloblastoma: Impact of reduced dose craniospinal irradiation and high-dose chemotherapy with autologous stem cell rescue
Abstract: Background: Data on ovarian function (OvF) in medulloblastoma (MB) survivors is limited, with most studies describing outcomes in survivors treated with craniospinal irradiation (CSI) doses >24Gy±standard chemotherapy. The objective of the current study is to report on OvF: (i) across a range of CSI doses; and (ii) following high-dose chemotherapy with autologous stem cell rescue (ASCR). Procedure: Retrospective review of female MB survivors who were diagnosed in childhood and followed at Memorial Sloan Kettering Cancer Center. Patients were divided into three groups: (i) CSI ≤24Gy+/-standard chemotherapy; (ii) CSI ≥35Gy+/-standard chemotherapy; and (iii) high-dose chemotherapy with ASCR+/-CSI. Results: Primary ovarian dysfunction (POD) occurred in 2/17 subjects in group 1, 3/9 subjects in group 2 and 5/5 subjects in group 3 (P<0.01). Normalization of function was noted in four subjects with POD. Persistent POD requiring hormone replacement (POF) was observed in 1/17 subjects in group 1, 2/9 in group 2, and 3/5 in group 3 (P=0.02). Neither age at treatment nor type of standard chemotherapy correlated with risk of POD or POF. Conclusions: Both POD and POF appear to occur in a small proportion of patients who are treated with contemporary doses of CSI+/-standard chemotherapy. However, ovarian dysfunction requiring hormone replacement therapy is common following high-dose chemotherapy associated with ASCR. These findings will assist clinicians in counseling patients regarding fertility preservation and risk of impaired ovarian function/future fertility. © 2014 Wiley Periodicals, Inc.
Keywords: medulloblastoma; craniospinal irradiation; premature ovarian failure; autologous stem cell rescue; ovarian function; primary ovarian dysfunction
Journal Title: Pediatric Blood and Cancer
Volume: 62
Issue: 2
ISSN: 1545-5009
Publisher: Wiley Periodicals, Inc  
Date Published: 2015-02-01
Start Page: 317
End Page: 321
Language: English
DOI: 10.1002/pbc.25291
PROVIDER: scopus
PUBMED: 25346052
DOI/URL:
Notes: Export Date: 4 May 2015 -- Source: Scopus
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MSK Authors
  1. Ira J Dunkel
    264 Dunkel
  2. Charles A Sklar
    285 Sklar
  3. Yasmin Khakoo
    102 Khakoo
  4. Suzanne L Wolden
    431 Wolden