Endocrinopathies in Survivors of Childhood Neoplasia

Abstract

Advancements in cancer treatments have increased the number of survivors of childhood cancers. Endocrinopathies are common complications following cancer therapy and may occur decades later. The objective of the current review is to address the main endocrine abnormalities detected in childhood cancer survivors including disorders of the hypothalamic-pituitary axis, thyroid, puberty, gonads, bone, body composition, and glucose metabolism.

Genetic variation and bone mineral density in long‐term adult survivors of childhood cancer

“…Especially endocrine complications occur frequently in CCSs. 2,3 These endocrine complications Abbreviations: AAD, alkylating agent dose; ALL, acute lymphoblastic leukemia; AMH, anti-Müllerian hormone; BMAD, bone mineral apparent density; BMD, bone mineral density; BMI, body mass index; CCS, childhood cancer survivor; DNA, deoxyribonucleic acid; DXA, dual x-ray absorptiometry; GWAS, genome-wide association study; LS, lumbar spine; MTX, methotrexate; SE, standard error; SNP, single-nucleotide polymorphism; SDS, standardized deviation score; TB, total body include an early impairment of bone mineral density (BMD) with consequent increased fracture risk, which can further result in disability and impairment of quality of life. 4,5 We and others described that low BMD in long-term adult CCSs is determined by male sex, younger age at diagnosis, older age at follow-up, underweight, and previous administered axial radiotherapy and steroids.…”

Obstetric and offspring risks of women’s morbid conditions linked to prior anticancer treatments

“… - Surgical removal of the uterine cervix in cervical cancer patients is associated with increased risk of second trimester loss (10 % of pregnancies) and premature delivery in the third trimester (19 % of pregnancies) (for review, see Knopman et al [ 4 ]). Musculoskeletal deficiencies in survivors of childhood cancer (for reviews, see Wasilewski et al [ 63 ], Barnes and Chemaitilly [ 2 ], and Wissing [ 64 ]). - Low bone mineral density - A deficit in bone mineral density is associated with increased susceptibility to fragility fractures in pregnancy or the puerperium that may result from the combination of abnormal skeletal microarchitecture prior to pregnancy and increased bone resorption during pregnancy (for review, see Kovacs [ 65 ]).…”

“…In fact, it is estimated that approximately two thirds of childhood cancer survivors experience at least one chronic medical problem. The other one third suffers from severe or life-threatening complications 30 years after diagnosis of their primary cancer, mostly due to adverse cardiovascular events, pulmonary dysfunction, or second malignancies including leukemias and a variety of solid tumors involving the thyroid gland, breast, cervix, corpus of the uterus, and ovaries (for reviews, see Barnes and Chemaitilly [ 2 ] and Travis et al [ 3 ]).…”

Understanding the endocrinopathies associated with the treatment of childhood cancer: part 2

“…Endocrinopathies are a well-recognised complication following treatment for cancer in childhood (Han et al 2009, Barnes andChemaitilly 2014). Collaborative working between paediatric endocrine LE and adult…”

“…These differences are emphasised by daily administration of replacement endocrine therapies, and concordance with therapy issues may arise. Early diagnosis and timely treatment of endocrine disorders can only improve overall health status for this vulnerable patient cohort (Barnes and Chemaitilly 2014).…”