Self-reported fertility in long-term survivors of acute myeloid leukemia |
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Authors: | Elsa Brånvall Åsa Rangert Derolf Eva Johansson Malin Hultcrantz Karin Bergmark Magnus Björkholm |
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Affiliation: | 1. Division of Hematology, Department of Medicine, Karolinska University Hospital Solna and Karolinska Institutet, 171 76, Stockholm, Sweden 2. Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden 3. Clinical Cancer Epidemiology, Department of Oncology and Pathology, Karolinska University Hospital Solna and Karolinska Institutet, Stockholm, Sweden
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Abstract: | Acute myeloid leukemia (AML) survival rates in younger patients have improved considerably since the 1970s. In order to evaluate the impact of AML and its treatment on fertility and family situation in adult long-term survivors, we used the Swedish population-based registries to identify 161 adult patients diagnosed with AML within the Leukemia Group of Middle Sweden (LGMS) 1973–2003, who survived for more than 5 years and were alive in 2010. Ninety-eight patients (61 %) completed a questionnaire including items on reproductive concerns, family situation, and infertility-related distress. After excluding women >45 years and/or postmenopausal women and men >55 years, 22 women and 38 men were included in the final analysis. Nine of the women (41 %) tried to conceive after treatment, but only three succeeded. Five (83 %) of the unwillingly childless women reported “a moderate” or “a lot” of distress caused by this. Among men in the same age group, all six who wanted children after treatment succeeded. None of the men 46–55 years old cryopreserved their sperm or tried to father a child. Among patients who wanted children after AML treatment, 46 % of the women and 40 % of the younger men reported that they were not, or not fully, informed about fertility-related issues. In contrast, among men 46–55 years, none reported they would have wanted more information. Infertility among young female AML survivors thus remains an important clinical issue, and there is a need for improved clinical counseling and education in this area. |
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