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Genetic variation in gonadal impairment in female survivors of childhood cancer: a PanCareLIFE study protocol
ALF. van der Kooi, E. Clemens, L. Broer, O. Zolk, J. Byrne, H. Campbell, M. van den Berg, C. Berger, G. Calaminus, U. Dirksen, JF. Winther, SD. Fosså, D. Grabow, R. Haupt, M. Kaiser, T. Kepak, L. Kremer, J. Kruseova, D. Modan-Moses, A. Ranft, C....
Language English Country England, Great Britain
Document type Journal Article, Multicenter Study
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BioMedCentral
from 2001-12-01
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Free Medical Journals
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- MeSH
- Anti-Mullerian Hormone analysis MeSH
- Genome-Wide Association Study MeSH
- Adult Survivors of Child Adverse Events MeSH
- Polymorphism, Single Nucleotide * MeSH
- Humans MeSH
- Menopause, Premature genetics metabolism MeSH
- Cancer Survivors MeSH
- Surveys and Questionnaires MeSH
- Check Tag
- Humans MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Multicenter Study MeSH
BACKGROUND: Improved risk stratification, more effective therapy and better supportive care have resulted in survival rates after childhood cancer of around 80% in developed countries. Treatment however can be harsh, and three in every four childhood cancer survivors (CCS) develop at least one late effect, such as gonadal impairment. Gonadal impairment can cause involuntary childlessness, with serious consequences for the well-being of CCS. In addition, early menopause increases the risk of comorbidities such as cardiovascular disease and osteoporosis. Inter-individual variability in susceptibility to therapy related gonadal impairment suggests a role for genetic variation. Currently, only one candidate gene study investigated genetic determinants in relation to gonadal impairment in female CCS; it yielded one single nucleotide polymorphism (SNP) that was previously linked with the predicted age at menopause in the general population of women, now associated with gonadal impairment in CCS. Additionally, one genome wide association study (GWAS) evaluated an association with premature menopause, but no GWAS has been performed using endocrine measurements for gonadal impairment as the primary outcome in CCS. METHODS: As part of the PanCareLIFE study, the genetic variability of chemotherapy induced gonadal impairment among CCS will be addressed. Gonadal impairment will be determined by anti-Müllerian hormone (AMH) levels or alternatively by fertility and reproductive medical history retrieved by questionnaire. Clinical and genetic data from 837 non-brain or non-bilateral gonadal irradiated long-term CCS will result in the largest clinical European cohort assembled for this late-effect study to date. A candidate gene study will examine SNPs that have already been associated with age at natural menopause and DNA maintenance in the general population. In addition, a GWAS will be performed to identify novel allelic variants. The results will be validated in an independent CCS cohort. DISCUSSION: This international collaboration aims to enhance knowledge of genetic variation which may be included in risk prediction models for gonadal impairment in CCS.
Boyne Research Institute Drogheda Ireland
Department of Internal Medicine Erasmus MC Rotterdam The Netherlands
Department of Oncology Oslo University Hospital Oslo Norway
Department of Pediatric Hematology and Oncology VU Medical Center Amsterdam The Netherlands
Epidemiology and Biostatistics Unit Istituto Giannina Gaslini Genoa Italy
Motol University Hospital Prague Czech Republic
Princess Máxima Center for Pediatric Oncology Lundlaan 6 3584 EA Utrecht The Netherlands
References provided by Crossref.org
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- $a van der Kooi, Anne-Lotte L F $u Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Erasmus MC - Sophia Children's Hospital, Rotterdam, The Netherlands. a.vanderkooi@erasmusmc.nl. Department of Pediatric Hematology and Oncology, Erasmus MC - Sophia Children's Hospital, Rotterdam, The Netherlands. a.vanderkooi@erasmusmc.nl. Princess Máxima Center for Pediatric Oncology, Lundlaan 6, 3584, EA, Utrecht, The Netherlands. a.vanderkooi@erasmusmc.nl.
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- $a BACKGROUND: Improved risk stratification, more effective therapy and better supportive care have resulted in survival rates after childhood cancer of around 80% in developed countries. Treatment however can be harsh, and three in every four childhood cancer survivors (CCS) develop at least one late effect, such as gonadal impairment. Gonadal impairment can cause involuntary childlessness, with serious consequences for the well-being of CCS. In addition, early menopause increases the risk of comorbidities such as cardiovascular disease and osteoporosis. Inter-individual variability in susceptibility to therapy related gonadal impairment suggests a role for genetic variation. Currently, only one candidate gene study investigated genetic determinants in relation to gonadal impairment in female CCS; it yielded one single nucleotide polymorphism (SNP) that was previously linked with the predicted age at menopause in the general population of women, now associated with gonadal impairment in CCS. Additionally, one genome wide association study (GWAS) evaluated an association with premature menopause, but no GWAS has been performed using endocrine measurements for gonadal impairment as the primary outcome in CCS. METHODS: As part of the PanCareLIFE study, the genetic variability of chemotherapy induced gonadal impairment among CCS will be addressed. Gonadal impairment will be determined by anti-Müllerian hormone (AMH) levels or alternatively by fertility and reproductive medical history retrieved by questionnaire. Clinical and genetic data from 837 non-brain or non-bilateral gonadal irradiated long-term CCS will result in the largest clinical European cohort assembled for this late-effect study to date. A candidate gene study will examine SNPs that have already been associated with age at natural menopause and DNA maintenance in the general population. In addition, a GWAS will be performed to identify novel allelic variants. The results will be validated in an independent CCS cohort. DISCUSSION: This international collaboration aims to enhance knowledge of genetic variation which may be included in risk prediction models for gonadal impairment in CCS.
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