Long-term ovarian reserve and fertility outcomes in female survivors of childhood acute lymphoblastic leukemia

Sarah Elitzur*, Shani Frank, Tal Goshen-Lago, Shlomit Barzilai-Birenboim, Gil Gilad, Galia Avrahami, Tracie Goldberg, Naomi Litichever, Ameena Masarwa, Galia Oron, Isaac Yaniv, Shai Izraeli, Irit Ben-Aharon

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Acute lymphoblastic leukemia (ALL) is the most common childhood malignancy, yet data regarding long-term ovarian reserve of female survivors are limited. The aim of this study was to investigate whether there is a differential pattern of anti-Mullerian hormone (AMH) levels in female childhood ALL survivors compared with the normal age-matched population. In a cohort of 56 female childhood ALL survivors (median age 29 years; median follow-up 20.6 years), a negative correlation was found between age at leukemia diagnosis and age-adjusted anti-Mullerian hormone (AMH) levels (r = −0.334, p =.031). Despite alkylating agent therapy, AMH levels did not differ significantly from age-related nomograms (age < 30, p =.17; age ≥ 30, p =.94). The mean number of children per fertile woman adjusted for maternal age was similar to the national average (2.76 versus 3.11, p =.19). Our results imply that reproductive outcomes are not significantly hampered in female pediatric ALL survivors. Long-term surveillance of ovarian reserve may enable personalized survivorship counseling.

Original languageEnglish
Pages (from-to)2211-2218
Number of pages8
JournalLeukemia and Lymphoma
Volume62
Issue number9
DOIs
StatePublished - 2021

Keywords

  • Acute lymphoblastic leukemia (ALL)
  • anti-Mullerian hormone (AMH)
  • children
  • fertility
  • ovarian reserve

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