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Cancer Research and Treatment > Epub ahead of print
doi: https://doi.org/10.4143/crt.2022.1518    [Epub ahead of print]
Gonadal Function in Female Adolescent and Young Adult Survivors of Childhood Cancer
Hye Young Jin , Jun Ah Lee, Meerim Park, Hyeon Jin Park
Department of Pediatrics, Center for Pediatric Cancer, National Cancer Center, Goyang, Korea
Correspondence  Hyeon Jin Park ,Tel: 82-31-920-1654, Fax: 82-31-920-1244, Email: hjpark@ncc.re.kr
Received: November 18, 2022;  Accepted: January 30, 2023.  Published online: January 31, 2023.
Childhood cancer survivors (CCSs) are at risk for premature ovarian insufficiency (POI). The aim of this study is to evaluate ovarian function and associated health outcomes in female adolescent and young adult survivors of childhood cancer.
Materials and Methods
Sixty-nine female CCSs were enrolled. Medical records of CCSs were retrospectively reviewed. The subjects were categorized into three groups according to follicular stimulating hormone (FSH) levels (cutoff, 12, 40 IU/L). Anti-müllerian hormone (AMH) level less than 1 ng/mL was considered low AMH level.
Of 69 subjects, 14 (20.3%) had POI and 14 (20.3%) had FSH levels between 12 and 40 IU/L. Forty-one of 69 (59.4%) had normal FSH levels. Pelvic irradiation and stem cell transplantation (SCT) were more frequently performed in subjects with POI (p=0.001 and p < 0.001). AMH levels were remarkably low when FSH levels were over 12 IU/L (p < 0.001). In multivariate analysis, cyclophosphamide equivalent dose and SCT were significant treatment factors for developing low AMH levels (p=0.005 and p=0.002, respectively). Total, low-density lipoprotein cholesterol and triglyceride were significantly different in three groups according to FSH levels (p=0.047, p=0.030, and p=0.045). Z-score of femur neck bone mineral density was significantly reduced when FSH levels were increased (p=0.011).
Gonadal dysfunction is common in CCSs. Gonadal function was associated with a few treatment factors known to increase the risk of POI. Regular monitoring of gonadal function is needed for better health outcomes.
Key words: Childhood cancer survivors, Premature ovarian insufficiency, Anti-müllerian hormone, Gonadal dysfunction
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