Premature ovarian insufficiency in pediatric cancer patients: a 10 year Rady Children’s Hospital experience
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Miranda Robinson
Abstract
Objectives
To highlight the occurrence of premature ovarian insufficiency in pediatric cancer patients and determine which patient characteristics or treatment modalities are associated with ovarian failure and recovery.
Methods
Between August 2011–August 2021, 36 of 2,661 patients with cancer were identified to have subsequent ovarian failure. Data collected included cancer type, diagnosis age, types of chemotherapy, bone marrow transplant or radiation treatment, peak follicle-stimulating hormone (FSH), peak anti-Mullerian hormone (AMH), gonadotropin releasing hormone agonist (GnRHa) treatment, type of hormone replacement therapy, and if ovarian function recovery occurred.
Results
The most common cancer type identified was ALL. The mean age of diagnosis was 8.5±4.3 years and mean age of peak FSH value was 12.6±2.8 years. Most patients (97.2 %) were treated with alkylating agents and 72.2 % received radiation. Most patients (72.2 %) received hormone therapy, and 15.8 % of patients received GnRHa Lupron. Ten patients (27.8 %) had ovarian function recovery. Diagnosis age and treatment type were recovery predictors in multivariate regression modeling. Each year older in age was associated with a 30 % decrease in odds of recovery (OR: 0.7, CI: 0.5–0.95, p=0.035), and alkylating agent treatment without transplant was associated with a 3-fold increase in odds of recovery (OR: 3, CI: 2.7–564, p=0.007).
Conclusions
This retrospective review demonstrates that POI can occur in pediatric cancer survivors, emphasizing the importance of educating patients on potential long-term effects of cancer treatment and importance of routine surveillance. This study confirmed that recovery of ovarian function is possible, especially when diagnosed at a younger age, making continued monitoring essential.
Acknowledgments
The authors acknowledge Zaineb Boulil, MS for assistance with statistical analyses.
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Research ethics: The IRB exempted the study from review.
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Informed consent: Not applicable.
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Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
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Use of Large Language Models, AI and Machine Learning Tools: None declared.
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Conflict of interest: The authors state no conflict of interest.
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Research funding: None declared.
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Data availability: Not applicable.
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© 2024 Walter de Gruyter GmbH, Berlin/Boston
Articles in the same Issue
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Articles in the same Issue
- Frontmatter
- Review
- Selecting optimal progestational agents either alone or in combination in common pediatric endocrine settings: challenges of unmet needs
- Original Articles
- Comparison of the effectiveness of prepubertal growth hormone treatment on height and predicted adult height in children with short stature born small for gestational age vs. with a growth hormone deficiency
- Expanded phenotypic spectrum in MODY 5 patients with 17q12 deletion syndrome: experience from an Indian tertiary care hospital
- Endocrine sequelae after pediatric craniopharyngioma treatment: a single-center retrospective cohort study
- Premature ovarian insufficiency in pediatric cancer patients: a 10 year Rady Children’s Hospital experience
- Alterations in optical coherence tomography and optical coherence tomography angiography findings in children with partial biotinidase deficiency
- Slow growth and short stature in children with attention deficit hyperactivity disorder (ADHD): a retrospective study of 493 children who underwent growth hormone provocation testing at one tertiary paediatric endocrine centre
- Short Communication
- Assessment of diabetes-specific knowledge and its determinants among children with type 1 diabetes mellitus and their primary caregivers: Experience from a tertiary care center in North India
- Letters to the Editor
- Comment on “Diagnostic utility of the average peak LH levels measured during GnRH stimulation test”
- Author’s reply “Comment on diagnostic utility of the average peak LH levels measured during GnRH stimulation test”
- Case Reports
- Estrogen-insensitivity syndrome (EIS) in a female adolescent patient – a case report
- The complexities of managing a newborn with 6q24 transient neonatal diabetes mellitus: a case report
- Homozygous mutation of KISS1 receptor (KISS1R) gene identified in a Chinese patient with congenital hypogonadotropic hypogonadism (CHH): case report and literature review
- Selpercatinib prior to radioactive iodine for pediatric papillary thyroid carcinoma
