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Cited by 29Reproductive Biology and FertilityNeuroblastoma Research and TreatmentsEffects of Radiation Exposure

Primary Ovarian Insufficiency in Children After Treatment With131I-Metaiodobenzylguanidine for Neuroblastoma: Report of the First Two Cases

Clement, S. C., Kraal, K. C. J. M., van Eck-Smit, B. L. F., van den Bos, C., Kremer, L. C. M., Tytgat, G. A. M., van Santen, H. M.·2014·The Journal of Clinical Endocrinology & Metabolism
DOI 10.1210/jc.2013-3595
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Abstract

BACKGROUND: Primary ovarian insufficiency (POI) is a noted late effect in childhood cancer survivors treated with alkylating agents or after radiation to a field that includes the ovaries. Gonadal failure in children with neuroblastoma (NBL) who were exposed to 131I- metaiodobenzylguanidine (MIBG) has only been reported in those who were also treated with chemotherapy. In these cases, the cause of gonadal failure was assumed to be the cytotoxic therapy. Here, we present the first two cases of POI after 131I-MIBG treatment only for NBL, indicating that 131I-MIBG treatment may have a causative role. PATIENTS: During follow-up after treatment for NBL in childhood, elevated gonadotropins were found in a 12-year-old girl and an 11-year-old girl (FSH values, 105 and 161 U/L, respectively), indicating POI. The first patient had been diagnosed at the age of 17 months with sacrally located (intraspinal) NBL. Treatment consisted of five courses of 131I-MIBG and local resection. The second patient had been diagnosed at the age of 8 months with an abdominal (intraspinal) NBL. She had been treated with acute (neuro) surgery for decompression of her intraspinal tumor causing neurological symptoms, followed by two courses of 131I-MIBG therapy. Both girls had normal karyotypes (46, XX). No other cause for the ovarian failure was found. Estrogen suppletion was started, and patients and parents were counseled regarding fertility options. CONCLUSION: These two cases suggest that exposure to 131I-MIBG may damage the female gonads. Clinicians caring for childhood cancer survivors should be aware of the risk of POI after 131I-MIBG treatment. Prospective studies are warranted to confirm our observations.

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  • External-beam irradiation of over 10 Gy can cause ovarian failure, which is also a toxicity identified in some female patients receiving MIBG treatment.

    “External-beam irradiation of over 10 Gy can cause ovarian failure, which is also a toxicity that has been identi fi ed in some female patients receiving MIBG treatment ( 100 ).”

    From Normal-Tissue Tolerance to Radiopharmaceutical Therapies, the Knowns and the Unknowns (2021) · cites this paper as [100]

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Authors
Clement, S. C., Kraal, K. C. J. M., van Eck-Smit, B. L. F., van den Bos, C., Kremer, L. C. M., Tytgat, G. A. M., & van Santen, H. M.
Affiliations
Amsterdam UMC Location University of Amsterdam (NL)
ORCID
Venue
The Journal of Clinical Endocrinology & Metabolism
Publisher
The Endocrine Society
Published
2014-01
Volume
99
Issue
1
Pages
E112-E116
ISSN
  • 0021-972X (ISSN-L)
  • 1945-7197
DOI
10.1210/jc.2013-3595
OpenAlex
W1981588870
Cited by
29
References
19
Citations by year
2025: 1 · 2024: 3 · 2022: 3 · 2021: 2 · 2020: 4 · 2019: 3 · 2018: 4 · 2017: 2 · 2016: 4 · 2015: 1 · 2014: 1 · 2013: 1
FWCI
2.38
Type
journal article
Language
en
Open access
closed
Locations
  • The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
  • PubMed (publishedVersion)
  • Pure Amsterdam UMC (publishedVersion)
  • Data Archiving and Networked Services (DANS) (submittedVersion)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Reproductive Biology and Fertility
  • Health Sciences › Medicine › Neurology › Neuroblastoma Research and Treatments
  • Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Effects of Radiation Exposure
Keywords
primary ovarian insufficiency, neuroblastoma, 131I-MIBG, metaiodobenzylguanidine, radioiodine therapy, gonadotoxicity, childhood cancer survivors, late effects of cancer treatment, fertility counseling, estrogen replacement therapy
MeSH terms
Antineoplastic Agents, Child, Female, Humans, Iodine Radioisotopes, Neuroblastoma, Radiation Injuries, Spinal Cord Compression, Spinal Neoplasms, Primary Ovarian Insufficiency, 3-Iodobenzylguanidine

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