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Pubertal development and fertility in survivors of childhood acute myeloid leukemia treated with chemotherapy only: A NOPHO‐AML study
Author(s) -
MolgaardHansen Lene,
Skou AnneSofie,
Juul Anders,
Glosli Heidi,
Jahnukainen Kirsi,
Jarfelt Marianne,
Jónmundsson Guðmundur K.,
Malmros Johan,
Nysom Karsten,
Hasle Henrik
Publication year - 2013
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.24715
Subject(s) - medicine , menarche , anti müllerian hormone , myeloid leukemia , fertility preservation , chemotherapy , hematopoietic stem cell transplantation , fertility , premature ovarian failure , cyclophosphamide , pediatrics , transplantation , hormone , population , environmental health
Abstract Background More than 60% of children with acute myeloid leukemia (AML) become long‐term survivors. Most are cured using chemotherapy without hematopoietic stem cell transplantation (HSCT). We report on pubertal development and compare self‐reported parenthood among AML survivors and their siblings. Procedure We included 137 children treated for AML according to the Nordic Society of Pediatric Hematology and Oncology (NOPHO)‐AML‐84, ‐88, and ‐93 trials, who were alive by June 2007. Patients with relapse or treated with HSCT were excluded. AML survivors participated in a physical and biochemical examination (n = 102) and completed a questionnaire (n = 101). One of their siblings completed an identical questionnaire (n = 84). Results At a median follow‐up of 11 years (range 5–25) after diagnosis of AML the survivors (median age 16 years, range 5–36) were either prepubertal or had entered puberty normally. Serum levels of FSH, LH, testosterone, estradiol, sex hormone binding globulin (SHBG), inhibin A and B, and testicular volumes were within normal ranges. Anti‐Müllerian hormone (AMH) levels were decreased in 5 of 40 postpubertal females. Mean reported age at menarche was 13.1 (range 11–17) years. Among survivors 15 years of age or older 31% of females reported pregnancies and 9% of males reported pregnancies in their partners, rates comparable with the frequency reported by their siblings. Conclusions Most AML survivors treated with chemotherapy had normal pubertal development and fertility, however, AMH levels were decreased in 13% of postpubertal females. Longer follow‐up is necessary to evaluate possible risk of premature ovarian failure. Pediatr Blood Cancer 2013;60:1988–1995. © 2013 Wiley Periodicals, Inc.