{Reference Type}: Journal Article
{Title}: Ovarian function in female survivors of high-risk neuroblastoma.
{Author}: Jimenez-Kurlander L;DeRosa A;Kostrzewa CE;Moskowitz CS;Bogardus K;Antal Z;Wolden S;La Quaglia MP;Basu EM;Cardenas FI;Kramer K;Kushner BH;Cheung NV;Modak S;Friedman DN;
{Journal}: Pediatr Blood Cancer
{Volume}: 71
{Issue}: 9
{Year}: 2024 Sep 5
{Factor}: 3.838
{DOI}: 10.1002/pbc.31181
{Abstract}: <B>BACKGROUND: </B>Data on ovarian function in neuroblastoma survivors are limited. We sought to determine the prevalence of ovarian dysfunction in a cohort of high-risk neuroblastoma survivors and compare outcomes among survivors treated with and without autologous stem cell rescue (ASCR) preceded by myeloablative chemotherapy.<BR><B>METHODS: </B>Retrospective review of female survivors of high-risk neuroblastoma ≥5 years from diagnosis, diagnosed between 1982 and 2014, and followed in a tertiary cancer center. Participants were divided into two groups: individuals treated with conventional chemotherapy ± radiation ("non-ASCR") (n = 32) or with chemotherapy ± radiation followed by myeloablative chemotherapy with ASCR ("ASCR") (n = 51). Ovarian dysfunction was defined as follicle-stimulating hormone ≥15 mU/mL, while premature ovarian insufficiency (POI) was defined as persistent ovarian dysfunction requiring hormone replacement therapy. Poisson models were used to determine prevalence ratios of ovarian dysfunction and POI.<BR><B>RESULTS: </B>Among 83 females (median attained age: 19 years [range, 10-36]; median follow-up: 15 years [range, 7-36]), 49 (59%) had ovarian dysfunction, and 34 (41%) developed POI. Survivors treated with ASCR were 3.2-fold more likely to develop ovarian dysfunction (95% CI: 1.8-6.0; p < 0.001) and 4.5-fold more likely to develop POI (95% CI: 1.7-11.7; p = 0.002) when compared with those treated with conventional chemotherapy, after adjusting for attained age. Two participants in the non-ASCR group and six in the ASCR group achieved at least one spontaneous pregnancy.<BR><B>CONCLUSIONS: </B>Ovarian dysfunction is prevalent in female high-risk neuroblastoma survivors, especially after ASCR. Longitudinal follow-up of larger cohorts is needed to inform counseling about the risk of impaired ovarian function after neuroblastoma therapy.