COSA:AYA cancer fertility preservation/Impact of cancer treatments on fertility/Table effects amenorrhea
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Fertility preservation for AYAs diagnosed with cancer: Guidance for health professionals. > COSA:AYA cancer fertility preservation/Impact of cancer treatments on fertility/Table effects amenorrhea
Table 2: Effect of cancer treatment on development of amenorrhea [1]
| Degree of Risk | Treatment Protocol | Common Usage |
|---|---|---|
| High risk: > 80% of women develop amenorrhea after treatment | Whole abdominal or pelvic radiation doses ≥ 6 Gy in adult women | Multiple cancers |
| Whole abdominal or pelvic radiation doses; ≥ 15 Gy in prepubertal girls and ≥ 10 Gy in postpubertal girls | Wilms tumor, neuroblastoma, sarcoma, Hodgkin lymphoma | |
| Total body irradiation (TBI) radiation doses (83% risk) [2] | Bone marrow transplantation, Stem cell transplantation (BMT/SCT) | |
| CMF, CEF, or CAF × 6 cycles in women age 40+ | Breast cancer | |
| Cyclophosphamide 5 g/m2 in women age 40+ | Multiple cancers | |
| Cyclophosphamide 7.5 g/m2in females age < 20 | NHL, neuroblastoma, ALL, sarcoma | |
| Alkylating chemotherapy (eg, cyclophosphamide, busulfan, melphalan) conditioning for transplantation | BMT/SCT | |
| Any alkylating agent (eg, cyclophosphamide, ifosfamide, busulfan, BCNU, CCNU) + TBI or pelvic radiation | BMT/SCT, ovarian cancer, sarcoma, neuroblastoma, Hodgkin lymphoma | |
| Protocols containing procarbazine (51% risk) [3]: MOPP, MVPP, COPP, ChIVPP, ChIVPP/EVA, MOPP/ABVD, COPP/ABVD | Hodgkin lymphoma | |
| Cranial/brain radiation ≥ 40 Gy | Brain tumour | |
| Intermediate risk: approximately 30%-70% of women develop amenorrhea after treatment | CMF, CEF, or CAF × 6 cycles in women age 30-39 | Breast cancer |
| AC in women age 40+ | Breast cancer | |
| BEACOPP protocol | Hodgkin lymphoma | |
| Whole abdominal or pelvic radiation 10 to < 15 Gy in prepubertal girls | Wilms tumour, neuroblastoma | |
| Whole abdominal or pelvic radiation 5 to 10 Gy in postpubertal girls, spinal radiation ≥ 25 Gy | Spinal tumour, brain tumour, neuroblastoma, relapsed ALL or NHL | |
| Low risk: < 20% of women develop amenorrhea | AC in women age 30-39 | Breast cancer |
| CMF, CEF, or CAF × 6 cycles in women age < 30 | Breast cancer | |
| Lower dose alkylating chemotherapy: ABVD (5% risk) [4], CHOP(q21), COP (in women aged 30-35) | Hodgkin lymphoma, NHL | |
| Anthracycline + cytarabine | AML | |
| Multiagent therapies | ALL | |
| Very low/no risk: negligible effect on menses | Methotrexate + fluorouracil | Breast cancer |
| Vincristine (used in multiagent therapies) | Leukaemia, Hodgkin lymphoma, NHL, neuroblastoma, rhabdomyosarcoma, Wilms tumour, Kaposi's sarcoma | |
| Radioactive iodine | Thyroid cancer | |
| Unknown risk | Paclitaxel, docetaxel (taxanes used in AC protocols) | Breast cancer |
| Oxaliplatin | Ovarian cancer | |
| Irinotecan | Colon cancer | |
| Bevacizumab | Colon, non–small-cell lung cancer | |
| Cetuximab | Colon, head and neck cancer | |
| Trastuzumab | Breast cancer | |
| Erlotinib | Non–small-cell lung, pancreatic cancer | |
| Imatinib | Chronic myeloid leukemia, GI stromal tumor |
Source: Levine J, Canada A, Stern CJ. Fertility preservation in adolescents and young adults with cancer J Clin Oncol 2010 Nov 10;28(32):4831-41 [Available at http://www.ncbi.nlm.nih.gov/pubmed/20458029].
References
- ↑ Levine J, Canada A, Stern CJ. Fertility preservation in adolescents and young adults with cancer. J Clin Oncol 2010 Nov 10;28(32):4831-41 Available from: http://www.ncbi.nlm.nih.gov/pubmed/20458029.
- ↑ Borgmann-Staudt A, Rendtorff R, Reinmuth S, Hohmann C, Keil T, Schuster FR, et al. Fertility after allogeneic haematopoietic stem cell transplantation in childhood and adolescence. Bone Marrow Transplant 2011 Apr 11 Available from: http://www.ncbi.nlm.nih.gov/pubmed/21478918.
- ↑ Behringer K, Breuer K, Reineke T, May M, Nogova L, Klimm B, et al. Secondary amenorrhea after Hodgkin's lymphoma is influenced by age at treatment, stage of disease, chemotherapy regimen, and the use of oral contraceptives during therapy: a report from the German Hodgkin's Lymphoma Study Group. J Clin Oncol 2005 Oct 20;23(30):7555-64 Available from: http://www.ncbi.nlm.nih.gov/pubmed/16234521.
- ↑ Leader A, Lishner M, Michaeli J, Revel A. Fertility considerations and preservation in haemato-oncology patients undergoing treatment. Br J Haematol 2011 May;153(3):291-308 Available from: http://www.ncbi.nlm.nih.gov/pubmed/21391973.