Journal of Clinical Oncology, Vol 21, Issue 4
(February), 2003: 716-721
© 2003 American Society for Clinical Oncology
Pregnancy Outcome of Partners of Male Survivors of Childhood Cancer: A Report From the Childhood Cancer Survivor Study
Daniel M. Green,
John A. Whitton,
Marilyn Stovall,
Ann C. Mertens,
Sarah S. Donaldson,
Frederick B. Ruymann,
Thomas W. Pendergrass,
Leslie L. Robison
From the Department of Pediatrics, Roswell Park Cancer Institute, and Department of Pediatrics, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY; Department of Biostatistics, Fred Hutchinson Cancer Research Center, and Department of Pediatrics, Children’s Hospital and Regional Medical Center, Seattle, WA; Department of Radiation Physics, The University of Texas M.D. Anderson Cancer Center, Houston, TX; Division of Pediatric Epidemiology and Clinical Research, University of Minnesota, Minneapolis, MN; Department of Radiation Oncology, Stanford University Medical Center, Stanford, CA; Department of Pediatrics, Children’s Hospital of Columbus, Columbus, OH.
Address reprint requests to Daniel M. Green, MD, Department of Pediatrics, Roswell Park Cancer Institute, Elm and Carlton Streets, Buffalo, NY 14263; email: daniel.green{at}roswellpark.org.
Purpose: This study was undertaken to determine the effect, if any, on pregnancy loss, live births, and birthweight of treatment for cancer diagnosed during childhood or adolescence.
Patients and Methods: We reviewed pregnancy outcome among sexually active male Childhood Cancer Survivor Study (CCSS) participants who responded to a questionnaire before February 3, 2000. Medical records of all members of the cohort were abstracted to obtain chemotherapeutic agents administered, the cumulative dose of drug administered for several drugs of interest, and the doses, volumes, and dates of administration of all radiotherapy.
Results: There were 4,106 sexually active males; 1,227 reported they sired 2,323 pregnancies (69% live births, 1% stillbirths, 13% miscarriages, 13% abortions, 5% unknown or in gestation). The male-to-female ratio of the offspring of the partners of the male survivors was significantly different from that of the offspring of the partners of the male siblings of the survivors (1.0:1.03 v 1.24:1.0) (P = .016). The proportion of pregnancies of the partners of male survivors that ended with a liveborn infant was significantly lower than for the partners of the male siblings of the survivors who were the control group for comparison (relative risk = 0.77, P = .007). There were no significant differences in pregnancy outcome by treatment.
Conclusion: This large study did not identify adverse pregnancy outcomes for the partners of male survivors treated with most chemotherapeutic agents. The reversal of the sex ratio and the association observed for procarbazine warrant further investigation.
Supported by the National Cancer Institute (U24 CA55727) of the National Institutes of Health.
Support provided to the University of Minnesota Cancer Center from the Children’s Cancer Research Fund.
Presented in part at the XXXI Annual Meeting of the International Society of Paediatric Oncology, Montreal, Canada, September 13–18, 1999 (Med Pediatr Oncol 33:146, 1999).
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