TY - JOUR
T1 - Menarche in a cohort of 188 long-term survivors of acute lymphoblastic leukemia
AU - Mills, J. L.
AU - Fears, T. R.
AU - Robison, L. L.
AU - Nicholson, H. S.
AU - Sklar, C. A.
AU - Byrne, J.
N1 - Funding Information:
The methods of the NICHD-NCI-CCG Leukemia Follow-Up Study have been described in detail previously. 7 Briefly, interviews were conducted with long-term survivors of childhood ALL who participated in the Children’s Cancer Group clinical trials. The CCG is a cooperative group of pediatric oncologists in the United States and Canada funded by the National Cancer Institute.
PY - 1997
Y1 - 1997
N2 - Objective: As more children survive acute lymphoblastic leukemia (ALL), questions are raised regarding how the disease and its therapy affect their pubertal development. Study design: The National Institute of Child Health and Human Development-National Cancer Institute-Children's Cancer Group Leukemia Follow-Up Study used a historical cohort design to investigate menarche in 188 ALL survivors who were pre-menarchal at diagnosis, aged at least 18 years, at least 2 years after diagnosis, alive, and in remission. Female siblings of ALL survivors (n = 218) served as control subjects. Results: Menarche occurred within the normal age range in 92% of survivors and 96% of the control subjects (p = 0.09). Early menarche occurred in four survivors (2%) and three control subjects (1%). Delayed, absent, or medically induced menarche was reported by 12 survivors (6%) and six control subjects (3%). Compared with the control subjects, survivors of ALL who received 1800 cGy cranial radiation before the age of 8 years had significantly earlier menarche, relative hazard (RH) of 2.2 (95% confidence interval: 1.4, 3.4 [p = 0.0003]). Survivors receiving 2400 cGy of craniospinal radiation with or without abdominal radiation had significantly later menarche than the control subjects, RH 0.4 (95% confidence interval: 0.3, 0.7 [p = 0.0002]). Conclusions: In this large cohort of ALL survivors, the risk of disordered menarche was low. However, younger subjects receiving 1800 cGy cranial radiation and those receiving 2400 cGy below the diaphragm required careful monitoring.
AB - Objective: As more children survive acute lymphoblastic leukemia (ALL), questions are raised regarding how the disease and its therapy affect their pubertal development. Study design: The National Institute of Child Health and Human Development-National Cancer Institute-Children's Cancer Group Leukemia Follow-Up Study used a historical cohort design to investigate menarche in 188 ALL survivors who were pre-menarchal at diagnosis, aged at least 18 years, at least 2 years after diagnosis, alive, and in remission. Female siblings of ALL survivors (n = 218) served as control subjects. Results: Menarche occurred within the normal age range in 92% of survivors and 96% of the control subjects (p = 0.09). Early menarche occurred in four survivors (2%) and three control subjects (1%). Delayed, absent, or medically induced menarche was reported by 12 survivors (6%) and six control subjects (3%). Compared with the control subjects, survivors of ALL who received 1800 cGy cranial radiation before the age of 8 years had significantly earlier menarche, relative hazard (RH) of 2.2 (95% confidence interval: 1.4, 3.4 [p = 0.0003]). Survivors receiving 2400 cGy of craniospinal radiation with or without abdominal radiation had significantly later menarche than the control subjects, RH 0.4 (95% confidence interval: 0.3, 0.7 [p = 0.0002]). Conclusions: In this large cohort of ALL survivors, the risk of disordered menarche was low. However, younger subjects receiving 1800 cGy cranial radiation and those receiving 2400 cGy below the diaphragm required careful monitoring.
UR - http://www.scopus.com/inward/record.url?scp=0031438472&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0031438472&partnerID=8YFLogxK
U2 - 10.1016/S0022-3476(97)70069-6
DO - 10.1016/S0022-3476(97)70069-6
M3 - Article
C2 - 9386666
AN - SCOPUS:0031438472
SN - 0022-3476
VL - 131
SP - 598
EP - 602
JO - Journal of Pediatrics
JF - Journal of Pediatrics
IS - 4
ER -