Background: Gonadal function is altered up to 25% in patients who suffered cancer in childhood. Cryopreservation of ovarian tissue (COT) is an option for preserving fertility.
Aims and objective: To establish the prevalence of primary hypogonadism (PH) in children with cancer after hematopoietic cell transplantation (HCT). To analyse the variables that predict progression to PH.
Methods: Retrospective cohort study. Patients aged 0 to 18 undergoing HCT from 20042014. Categorical variables in %, continuous normal in mean (S.D.), non-normal in median (P25P75). Independent variables: age at transplantation, gender, total body irradiation (TBI), busulfan, cyclophosphamide, COT. Dependent variable: PH. Multivariable logistic regression (LR). Statistical significance P-value <0.05.
Results: 75 patients underwent HCT, table 1. 30 developed PH, 19 women, 11 men. Age of onset of PH 11.97 years (S.D. 3.22). 9 women underwent COT, all developed PH. Characteristics: current age 15.58 years (S.D. 3.53), age at HCT 11.59 (S.D. 2.88), 44.4% received TBI, 11.1% abdominal radiotherapy, 33.3% busulfan, 11.1% melphalan, maximum FSH 79.63 mU/ml (S.D. 39.24). Characteristic of the other ten women with PH: current age 12.41 years (S.D. 4.88), age at HCT 5.98 (S.D. 3.61), 0% TBI, 30% abdominal radiotherapy, 90% busulfan, 40% melphalan, maximum FSH 43.75 mU/ml (S.D. 21.40). In LR model, sex (P=0.000) and age at time of HCT (P=0.003), independently predict progression to PH. RL was also performed excluding patients under ten and we found the same results.
|Gender||25 women, 50 men|
|Current age||13.31 years (S.D. 4.26)|
|Age at HCT||7.81 (S.D. 4.23)|
|Conditioning regimen||52.33% busulfan, 18.66% melphalan, 77.3% cyclophosphamide|
Conclusions: Women and patients older at time of HCT are more likely to develop PH. In girls with PH, FSH is greater in those who underwent COT, but these girls probably received a more gonadotoxic treatment.
01 - 03 Oct 2015
European Society for Paediatric Endocrinology