No abstract

Research has established that childhood cancer treatments can place survivors at risk for reproductive health problems, yet little is known about pediatric survivors' perceptions of their risk for infertility and worry about future family planning. The purpose of this study was to explore factors that affect awareness of risk for and worry about infertility among female pediatric cancer survivors aged 10 to 21 (N=48) and their parents (N=41) following exposure to treatments associated with reproductive late effects. The majority of female childhood cancer survivors (71%) and their parents (95%) reported worry about infertility following gonadotoxic therapy. Cross-sectional data indicated that survivors' awareness of risk for and worry about infertility increase during adolescence, whereas parents' awareness of risk and worry generally remain constant throughout their daughters' development. Survivor worry about infertility was predicted by a variety of factors, yet parent worry about infertility was only associated with increased gonadotoxic radiation exposure. Overall, these findings reinforce the necessity of developmentally appropriate education about reproductive health risks and fertility preservation options across the continuum of pediatric oncology care from diagnosis to survivorship.

AMH levels do not vary by race/ethnicity, and AMH levels increase with age.

Objectives: This study describes the hormone profiles for gonadal late effects after alkylator-based hematopoietic stem cell transplant (HSCT) regimens used for sickle-cell disease (SCD). Methods: This is a retrospective chart review of subjects followed in the post-HSCT clinic for sickle-cell disease. Patient demographics, pubertal development, characteristics of pre-HSCT disease severity, treatment before HSCT, conditioning regimens, presence of graft versus host disease and follicle-stimulating hormone, anti-Müllerian hormone (AMH), luteinizing hormone and testosterone were abstracted from the medical record. Results: Forty subjects (24 female individuals) with SCD were 9 (±4.3) years old at HSCT and 7.9 years (±5.6) from HSCT. At the time of transplant, 8% of female individuals and no male individuals were pubertal and 58% of female individuals and 38% of male individuals had been treated with hydroxyurea. Post-HSCT, all of the female individuals had diminished ovarian reserve on the basis of low AMH values and 10 of the pubertal female individuals (71%) had premature ovarian insufficiency defined as follicle-stimulating hormone >40 mIU/mL ×2. There was no ovarian recovery and AMH remained very low or undetectable up to 13 years post-HSCT. In male individuals, luteinizing hormone and testosterone levels were normal for age. Conclusions: Post-HSCT for SCD, all female individuals had diminished ovarian reserve and most female individuals had POI, whereas male individuals had normal testosterone hormone production.

Overall parental interest in CGM was high. Use of CSII, frequent BG checks, and parental worry, but not age of the child or diabetes control, were associated with parental interest in using a CGM.