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Roschina et al. (Abstract)

Cellular Therapy and Transplantation (CTT), Vol. 3, No. 9
doi: 10.3205/ctt-2010-No9-abstract34
© The Authors. This abstract is provided under the following license: Creative Commons Attribution 3.0 Unported

Abstract accepted for "4th Raisa Gorbacheva Memorial Meeting on Hematopoietic Stem Cell Transplantation",
Saint Petersburg, Russia, September 18–20, 2010

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The role of endocrine status in childhood cancer survivors: a quality of life evaluation

Natalia V. Roschina1, Svetlana A. Safonova1, Eugenia V. Tsyrlina1, Ilya V. Kazantsev2, Yuri A. Punanov1, Lev M. Berstein1

1N.N. Petrov Research Institute of Oncology, Saint- Petersburg, Russia; 2R.M. Gorbacheva Memorial Institute of Children Hematology and Transplantation, Saint- Petersburg, Russia

Correspondence: Yuri A. Punanov, N.N. Petrov Research Institute of Oncology, 68 Leningradskaya str., 197758, Saint-Petersburg, Russia. E-mail: punanovyu55@spam is badyandex.ru

Abstract

Endocrine status is one of the key parameters for the quality of life evaluation in childhood cancer survivors, as thyroid gland and gonads (ovaries and testes) are very vulnerable to chemo- and radiotherapy. This study was aimed at the evaluation of the endocrine status (mainly thyroid and gonadal state) in childhood cancer survivors.

Patients and methods: We evaluated thyroid and gonadal axis hormone levels of 53 outpatients who were diagnosed with cancer and underwent therapy between 1982 and 1997 as children and adolescents. The mean age at the time of diagnosis was 13 years 7 months (3 months–16 years), and their mean current age is 21 years 9 months (9–33 years). The male-female ratio is 0.89:1. The patients had the following tumors: malignant lymphoma (n=27), Wilms’ tumor (n=8), neuroblastoma (n=4), Ewing’s sarcoma (n=4), germ cell tumor (n=3), rhabdomyosarcoma (n=2), osteosarcoma (n=2), lyposarcoma (n=1), malignant schwannoma (n=1), synovial sarcoma (n=1). One of these patients suffered from metachronous tumors (malignant lymphoma in 1995 and thyroid cancer in 1998). 52 patients received several courses of programmed chemotherapy; in 24 patients it was combined with surgery and in 22 with radiation. One patient received only surgical treatment. 52 of these patients are now in complete remission, and the patient with synovial sarcoma relapsed after 15 years of primary treatment.

Results: Mean TSH, FSH, LH and estradiol levels were within age norm. Five patients were diagnosed with subclinical hypothyroidism, and anti-thyroglobulin antibodies were found in 4 patients. Four of the 28 female patients had amenorrhea (14.2%): 2 of them received ilioinguinal lymph nodes and pelvic irradiation (50 Gr), one received a hysterectomy, and one patient received high-dose chemotherapy with autologous stem cell transplantation.

Conclusion: The most severe consequences affecting quality of life and reproductive status are observed in patients who underwent a combination of programmed chemotherapy and local neck irradiation or pelvic irradiation with a total dose of more than 40 Gr.

Keywords: endocrine status, childhood cancer, quality of life

 

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