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Fertility preservation in pediatric central nervous system tumors: A report from the Children's Oncology Group

James Felker1,2, Kari Bjornard3,4, Allison Close5

  • 1Division of Hematology/Oncology, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.

Pediatric Blood & Cancer
|August 10, 2024
PubMed

Insights

Pediatric cancer patients receiving gonadotoxic therapies face significant infertility risks. Many central nervous system (CNS) protocols place males and females at high risk, underscoring the need for fertility preservation counseling.

Area of Science:

  • Pediatric Oncology
  • Reproductive Endocrinology
  • Cancer Treatment Complications

Background:

  • Gonadotoxic therapies used in cancer treatment pose risks of infertility.
  • The Oncofertility Consortium has provided recommendations on these risks.
  • Understanding specific risks within pediatric cancer protocols is crucial.

Purpose of the Study:

  • To evaluate the risk levels of infertility associated with gonadotoxic therapies in pediatric central nervous system (CNS) cancer protocols.
  • To identify specific protocols and patient groups at higher risk for gonadal dysfunction.

Main Methods:

  • Extracted gonadotoxic therapies from Children's Oncology Group (COG) CNS protocols (2000-2022).
  • Assigned risk levels (unknown, minimal, significant, high) for gonadal dysfunction/infertility.
  • Analyzed risk distribution among males, pubertal females, and prepubertal females.

Main Results:

  • Seven out of 11 CNS protocols included at least one treatment arm with a high risk of infertility.
  • Males were most frequently in high-risk categories (7/11 protocols).
  • Pubertal females (6/11) and prepubertal females (5/11) also faced significant risks.

Conclusions:

  • Pediatric CNS cancer protocols frequently involve gonadotoxic therapies with high infertility risks.
  • Males and females, particularly those of pubertal age, are significantly affected.
  • Pre-treatment counseling on fertility preservation is essential for affected pediatric patients.
Keywords:
brain and spinal cord tumorsfertility preservationoncofertility

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