Acute AEs related to ZA infusion in youths are common, occur principally after the first ZA infusion in bisphosphonate-naive patients, and are typically mild and easily managed. Future prospective studies are needed to determine the potential long-term risks, as well as benefits, of ZA therapy in the pediatric population.
The 5-mm TST cut point did not capture IAC with risk factors for latent TB infection or progression to TB disease, suggesting that this is not a useful screening threshold. In contrast, a 10-mm cut point identified IAC at risk for TB infection and therefore should be a more useful screening threshold. We question the clinical utility of radiographic screening for pulmonary TB in asymptomatic children.
Background
: Providers often rely on self‐reported ovarian function in adolescent and young adult (AYA)‐aged childhood cancer survivors when making clinical decisions. This study described reported menstrual patterns and the agreement between respondent‐reported and biochemical premature ovarian insufficiency (POI) in this population.
Procedure
This was a cross‐sectional study of survivors (or their parent proxy) aged 13‐21.9 years who received gonadotoxic therapy and were enrolled in a longitudinal health survey. Participants reported menstrual regularity, hormone‐replacement therapy (HRT) use, and ovarian dysfunction. Respondent‐reported POI was defined as the survivor taking HRT for ovarian failure or having been told she had ovarian failure. Biochemical POI was defined as follicle‐stimulating hormone (FSH) level ≥40 mIU/mL. The agreement between respondent‐reported and biochemical POI was determined using Cohen's kappa coefficient (κ) and analyzed by demographic and clinical factors.
Results
Among 182 AYA‐aged survivors (72.5% non‐Hispanic White, 46.7% leukemia survivors), 14.8% reported requiring HRT to have menses but 55.5% reported regular menses without HRT use. Among survivors with FSH measurements (n = 130), 17.7% reported POI whereas 18.5% had FSH ≥40 mIU/mL (κ = 0.66, sensitivity 70.8%, specificity 94.3%). The highest agreement between respondent‐reported and biochemical POI was with young adult self‐report (κ = 0.78) and survivors with >5 survivor clinic (κ = 0.83) and/or >5 endocrinologist (κ = 1.00) visits.
Conclusions
The majority of AYA‐aged survivors reported having regular menses without HRT support. The accuracy of respondent‐reported POI increased with repeated survivor clinic or endocrinologist visits, highlighting the importance of continued education. Survivors must be informed about their ovarian function to enable them to advocate for their reproductive health.
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