Association Between Treatment of Childhood Cancer and Its Late Effects on Gonadal or Growth Function in Childhood Cancer Survivors: A Retrospective Observational Study

Background: The late effects on childhood cancer survivors have long been recognized, but detailed studies remain limited. The current study aimed to clarify the association between childhood cancer treatment and the incidence of late effects on gonadal or growth function in Japan. Methods: The retrospective study included medical records of patients with childhood cancer aged up to 15 years at diagnosis, who were treated with anticancer drugs at Osaka University Hospital from January 1, 2001, to December 31, 2019, and who survived at least 5 years after diagnosis. The patients' clinical background, treatment details, and anticancer drugs used were investigated. Multivariate logistic regression analysis was performed to assess the association between childhood cancer treatment and late effects on gonadal or growth function. Results: Of the 191 eligible patients, 83 (43.5%) developed gonadal dysfunction and 38 (19.9%) developed growth dysfunction. Multivariate logistic regression analysis showed statistically significant associations of gonadal dysfunction with female sex (odds ratio [OR], 4.79; p < 0.01), autologous hematopoietic stem cell transplantation (auto-HSCT) (OR, 9.97; p < 0.01), allogeneic hematopoietic stem cell transplantation (allo-HSCT) (OR, 9.48; p < 0.01), and platinum use (OR, 4.49; p = 0.037), and of growth dysfunction with auto-HSCT (OR, 5.16; p < 0.01). Conclusion: Female sex, allo-HSCT, and use of platinum are possibly associated with an increased risk of late effects on gonadal function, while auto-HSCT may pose a risk for late effects on both gonadal and growth functions. These findings should be interpreted with caution due to the limitations of the dataset and warrant further investigation to validate these associations.