Female Reproductive Health After Childhood, Adolescent, and Young Adult Cancers: Guidelines for the Assessment and Management of Female Reproductive Complications

• Authors: Monika L. Metzger, St Jude Children's Research Hospital; Lillian R Meacham, Emory University; Briana Patterson, Emory University; Jacqueline S. Casillas, University of California Los Angeles; Louis S. Constine, University of Rochester; Nobuko Hijiya, Northwestern University; Lisa B. Kenney, Dana Farber Cancer Institute; Marcia Leonard, University of Michigan; Barbara A. Lockart, Ann and Robert H. Lurie Children’s Hospital of Chicago; Wendy Likes, University of Tennessee; Daniel M. Green, St Jude Children's Research Hospital
• Journal Title: Journal of Clinical Oncology
• Volume: Volume 31, Number 9
• Publisher: American Society of Clinical Oncology | 2013-03-20, Pages 1239-1247
• Type of Work: Article | Final Publisher PDF
• Publisher DOI: http://doi.org/10.1200/JCO.2012.43.5511
• Subjects: Health Sciences, Oncology; Health Sciences, Obstetrics and Gynecology
• Keywords: Science & Technology; Life Sciences & Biomedicine; Oncology; ANTI-MULLERIAN HORMONE; CENTRAL PRECOCIOUS PUBERTY; TERM-FOLLOW-UP; ACUTE LYMPHOBLASTIC-LEUKEMIA; CRYOPRESERVED OVARIAN TISSUE; VERSUS-HOST-DISEASE; FERTILITY PRESERVATION; HODGKINS-DISEASE; BREAST-CANCER; REPLACEMENT THERAPY

Abstract

Purpose: As more young female patients with cancer survive their primary disease, concerns about reproductive health related to primary therapy gain relevance. Cancer therapy can often affect reproductive organs, leading to impaired pubertal development, hormonal regulation, fertility, and sexual function, affecting quality of life. Methods: The Children's Oncology Group Long-Term Follow-Up Guidelines for Survivors of Childhood, Adolescent, and Young Adult Cancer (COG-LTFU Guidelines) are evidence-based recommendations for screening and management of late effects of therapeutic exposures. The guidelines are updated every 2 years by a multidisciplinary panel based on current literature review and expert consensus. Results: This review summarizes the current task force recommendations for the assessment and management of female reproductive complications after treatment for childhood, adolescent, and young adult cancers. Experimental pretreatment as well as post-treatment fertility preservation strategies, including barriers and ethical considerations, which are not included in the COG-LTFU Guidelines, are also discussed. Conclusion: Ongoing research will continue to inform COG-LTFU Guideline recommendations for follow-up care of female survivors of childhood cancer to improve their health and quality of life.