ESPE Yearbook of Paediatric Endocrinology

To read the full abstract: Pediatr Blood Cancer. 2019;66(12):e27981. sgeorg4@emory.edu

This cross-sectional study tested the concordance between young adult (or parent proxy)-reported premature ovarian insufficiency (POI) and biochemical evidence of POI, defined as FSH ≥40 mIU/ml, in 182 childhood cancer survivors (CCS) who had received gonadotoxic therapy. Reported POI was defined as the survivor taking hormone replacement therapy (HRT) for ovarian failure or having been told they were affected by ovarian failure. 85% of CCS reported a spontaneous menarche; 55.5% reported regular menses without HRT use, and 14.8% reported requiring HRT to have menses. Overall, 71.4% of CCS had been screened for biochemical POI; these CCS were more likely to be older, to use hormonal therapy and to have been seen in the survivor clinic and/or by an endocrinologist at least once prior to the survey. Among them, 17.7% reported POI whereas 18.5% had FSH ≥40 mIU/ml (moderate agreement). The highest agreement between patient-reported and biochemical POI was with young adult survivors with >5 survivor clinic and/or endocrinologist visits. The large cohort of adolescent and young adult female CCS investigated for menstrual patterns and POI represents a significant strength of this study. However, it is surprising that only 71% of the study population underwent FSH levels assessment and the definition of biochemical POI was limited to at least one elevated FSH level and did not include a history of menstrual irregularities.

Continuous education is crucial for young CCS and their parents; in particular, they should be appropriately informed about their ovarian function prior to transition to adult care, so that they can take care of their reproductive health, particularly in medical settings outside of survivor clinics.