Conflict of interest: Nothing to declare.
Pubertal development and fertility in survivors of childhood acute myeloid leukemia treated with chemotherapy only: A NOPHO-AML study
Article first published online: 23 AUG 2013
© 2013 Wiley Periodicals, Inc.
Pediatric Blood & Cancer
Volume 60, Issue 12, pages 1988–1995, December 2013
How to Cite
Molgaard-Hansen, L., Skou, A.-S., Juul, A., Glosli, H., Jahnukainen, K., Jarfelt, M., Jónmundsson, G. K., Malmros, J., Nysom, K., Hasle, H. and On behalf of the Nordic Society of Pediatric Hematology and Oncology (NOPHO) (2013), Pubertal development and fertility in survivors of childhood acute myeloid leukemia treated with chemotherapy only: A NOPHO-AML study. Pediatr. Blood Cancer, 60: 1988–1995. doi: 10.1002/pbc.24715
- Issue published online: 8 OCT 2013
- Article first published online: 23 AUG 2013
- Manuscript Accepted: 8 JUL 2013
- Manuscript Received: 9 NOV 2012
- Danish Cancer Society
- The Danish Childhood Cancer Foundation
- The Karen Elise Jensen Foundation
- The Swedish Childhood Cancer Foundation
- acute myeloid leukemia;
- late effects;
- premature ovarian failure;
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.
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).
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.
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.