Table 2.
POI Prevalence Data Extracted by Study
| Study Details | Age, y | na | Cancer | Treatment | Method | Prevalence | Risk Factors | Notes | MMAT (%) |
|---|---|---|---|---|---|---|---|---|---|
| Livesey et al,11 1990 (UK) | Median age at treatment, 6.7 (range, 1.3–15); median age at study, 9.6 | 67 | Brain tumor | 100% cranial RT and some also received spinal Some also received adjuvant chemo |
Hormone measurement | 26.8% | Cranial RT combined with either spinal RT OR adjuvant chemo | No child treated with cranial RT alone experienced gonadal dysfunction | 75 |
| Byrne et al,12 1992 (US) | At diagnosis, age range: 13–19 | 954 | Various | RT and/or chemo | Self-report/questionnaire | 42.0% (by age 31 y) | Cancer diagnosis after age 12 years (RR, 2.32; 95% Cl, 1.63–3.29) RT alone (RR, 3.7) Alkylating agents alone (RR, 9.2) Both RT and alkylating agents (RR, 27.39; 95% Cl, 2.67–31.49) |
75 | |
| Mackie et al,13 1996 (UK) | Mean age at diagnosis, 13.0 (range, 9.0–15.2) | 32 | HL | ChlVPP | Hormone measurement | 31,25% | 60% of survivors with POI were taking HRT | 100 | |
| Teinturier eta 1,14 1998 (France) | Median age at treatment, 9 (range, 2–17); age at study, 14.5 (range, 11.5–21) | 21 | 85.7% solid tumors; 14.3% hematologic | High-dose chemo and autologous BMT without abdominal/pelvic RT | Hormone measurement | 57.1% | B us u If an | 100% of girls treated with busulfan had evidence of POI vs 27% of those who did not receive it | 100 |
| Chlarelli et al,151999 (Canada) | Age at diagnosis < 20; median age at study, 28 (range, 18–49) | 719 | 60.1 % solid tumors; 39.9% hematologic | Chemo, surgery, and/or RT | Self-report/questionnaire | 8.8% | Alkylating agents and abdominal/pelvic RT {RR, 2.58; 95% G, 1.14–5.80) | 75 | |
| Larsen et al,16 2003 (Denmark) | Median age at diagnosis, 5.4 (range, 0.1–15.3); median age at study, 25.7 (range, 18.5–44.4) | 100 | 37% solid tumors; 63% hematologic | 100% chemo; 56% RT; 12% BMT’ 37% surgery | Hormone measurement and transvagina I sonography | 17% | 100 | ||
| Sklar et al,17 2006 (US, Canada) | Median age at diagnosis, 7 (range, 0–20); age at study, 29 (range, 18–50) | 2,819 | 45% solid tumors; 55% hematologic | 10% surgery only; 10% chemo only; <1 % RT only; 17% chemo + RT; 20% surgery + chemo; 8% surgery + RT; 33% surgery + RT + chemo; 1% stem cell transplant | Self-report/questionnaire | 15% (RR, 1.05; 95% Cl, 1.04–1.07 vs siblings); 8% nonsurgical POI | Older age at diagnosis and follow-up Diagnosis of HL Exposure to alkylating agents Exposure to abdominal/pelvic radiation |
100 | |
| Mansky et al,18 2007 (US) | Median age at treatment, (range, 7.1–34.2); median age at study, (range, 17.5–55.4) | 15 | Sarcomas | Chemo + RT | Self-report/questionnaire | 49% | 75 | ||
| Green et al,19 2009 (US, Canada) | All cancers diagnosed at age<18 | 2,819 | Not described | Not described | Self-report/questionnaire | 8% | Attained age Exposure to increasing doses of radiation to the ovaries Increasing alkylating agent exposure Diagnosis of HL |
75 | |
| Thomas- Teinturier et al,20 2013 (France) | Median age at diagnosis, 4 (range, 0–17); median age at study, 36 (range, 21–66) | 706 | 85% solid tumors; 15% hematologic | 9% no chemo or RT; 29.5% chemo; 13% RT; 48.5% chemo + RT | Self-report/questionnaire | 2.1% | Alkylating agents (RR, 9; 95% Cl, 2.7–18) Radiation to ovaries Procarbazine dose Cyclophosphamide dose Unilateral oophorectomy |
75 |
Abbreviations: aHSCT, autologous hematopoietic stem cell transplantation; ALL, acute lymphoblastic leukemia; BMT, bone marrow transplant; CED, cyclophosphamide equivalent dose; chemo, chemotherapy; ChlVPP, chlorambucil/vinblastine/procarbazine/prednisolone; CNS, central nervous system; HL, Hodgkin lymphoma; HR, hazard ratio; HRT, hormone replacement therapy; MMAT, Mixed Methods Appraisal Tool; POI, primary ovarian insufficiency, RR, relative risk; RT, radiotherapy.
a
The number of patients reflects only the female cancer survivors in each study; some of these studies included male survivors and/or healthy controls, but these numbers are not reflected.