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Item Fertility Preservation in Pediatric Leukemia and Lymphoma: A Report from the Children’s Oncology Group(Wiley, 2023) Close, Allison; Burns, Karen; Bjornard, Kari; Webb, Martine; Chavez, Josuah; Chow, Eric J.; Meacham, Lillian; Pediatrics, School of MedicineCertain chemotherapy agents, radiation, and surgery can all negatively impact future fertility. Consults regarding treatment-related risk for infertility and gonadal late effects of these agents should occur at the time of diagnosis as well as during survivorship. Counseling on fertility risk has traditionally varied significantly across providers and institutions. We aim to provide a guide to standardize the assignment of gonadotoxic risk, which can be used in counseling patients both at the time of diagnosis and in survivorship. Gonadotoxic therapies were abstracted from 26 frontline Children's Oncology Group (COG) phase III protocols for leukemia/lymphoma, in use from 2000-2022. A stratification system based on gonadotoxic therapies, sex, and pubertal status was used to assign treatments into minimal, significant, and high level of increased risk for gonadal dysfunction/infertility. Risk levels were assigned to protocols and different treatment arms to aid oncologists and survivor care providers in counseling patients regarding treatment-related gonadotoxicity. Males were most commonly at high risk, with at least one high-risk arm in 14/26 protocols (54%), followed by pubertal females (23% of protocols) and prepubertal females (15% of protocols). All patients who received direct gonadal radiation or hematopoietic stem cell transplant (HSCT) were considered at high risk. Partnering with patients and their oncology/survivorship team is imperative for effective fertility counseling both prior to and post treatment, and this comprehensive guide can be used as a tool to standardize and improve reproductive health counseling in patients undergoing COG-based leukemia/lymphoma care.Item Impact of a novel family-centered values clarification tool on adolescent sperm banking attempts at the time of a new cancer diagnosis(Springer, 2021) Nahata, Leena; Dattilo, Taylor M.; Olsavsky, Anna L.; Lipak, Keagan G.; Whiteside, Stacy; Yeager, Nicholas D.; Audino, Anthony; Klosky, James L.; Rausch, Joseph; Saraf, Amanda; O’Brien, Sarah H.; Quinn, Gwendolyn P.; Gerhardt, Cynthia A.; Pediatrics, School of MedicinePurpose: Over half of males experience fertility impairment after childhood cancer therapy, which often causes psychosocial distress. Yet, fertility preservation (FP) remains underutilized. The goals of this study were to determine the feasibility and impact of implementing a family-centered FP values clarification tool on sperm banking attempts among adolescent males newly diagnosed with cancer, and identify key determinants of banking attempts. Methods: A prospective pilot study was conducted among families of males (12-25 years old), prior to cancer therapy. Thirty-nine of 41 families agreed to participate (95%); 98 participants (32 adolescents, 37 mothers, 29 fathers) completed the Family-centered Adolescent Sperm banking values clarification Tool (FAST). Analyses assessed the impact of the FAST on banking attempts and examined associations between demographic/medical characteristics, FAST subscales (perceived threat, benefits, barriers), and banking attempts. Results: Twenty-three (59%) adolescents attempted to bank, compared to 8 adolescents (33%) during baseline assessment (p=.04). Significant associations were identified between banking attempts and adolescents' report of perceived threat (rpb=.45, p=.01) and benefits (rpb=.57, p=.01). Only mothers' proxy reports of adolescent perceived threat (rpb=.42, p=.01) and benefits (rpb=.47, p=.003) were associated with banking attempts, while fathers' self-reported perceived benefits (rpb=.43, p=.03), self-reported barriers (rpb=.49, p=.01), and proxy reports of adolescent perceived threat (rpb=.38, p=.04) and benefits (rpb=.59, p=.02) were associated with banking attempts. Conclusion: Adolescent sperm banking attempt rates significantly increased after implementation of a family-centered FP values clarification tool prior to cancer treatment. Findings underscore the importance of targeting both adolescents and their parents, particularly fathers, in FP efforts.Item The National Physicians Cooperative: transforming fertility management in the cancer setting and beyond.(Future Medicine, 2018-12) Smith, Brigid M.; Duncan, Francesca E.; Ataman, Lauren; Smith, Kristin; Quinn, Gwendolyn P.; Chang, R. Jeffrey; Finlayson, Courtney; Orwig, Kyle; Valli-Pulaski, Hanna; Moravek, Molly B.; Zelinski, Mary B.; Irene Su, H.; Vitek, Wendy; Smith, James F.; Jeruss, Jacqueline S.; Gracia, Clarisa; Coutifaris, Christos; Shah, Divya; Nahata, Leena; Gomez-Lobo, Veronica; Appiah, Leslie Coker; Brannigan, Robert E.; Gillis, Valerie; Gradishar, William; Javed, Asma; Rhoton-Vlasak, Alice S.; Kondapalli, Laxmi A.; Neuber, Evelyn; Ginsberg, Jill P.; Muller, Charles H.; Hirshfeld-Cytron, Jennifer; Kutteh, William H.; Lindheim, Steven R.; Cherven, Brooke; Meacham, Lillian R.; Rao, Pooja; Torno, Lilibeth; Sender, Leonard S.; Vadaparampil, Susan T.; Skiles, Jodi L.; Schafer-Kalkhoff, Tara; Frias, Oliva J.; Byrne, Julia; Westphal, Lynn M.; Schust, Danny J.; Klosky, James L.; McCracken, Kate A.; Ting, Alison; Khan, Zaraq; Granberg, Candace; Lockart, Barbara; Scoccia, Bert; Laronda, Monica M.; Mersereau, Jennifer E.; Marsh, Courtney; Pavone, Mary Ellen; Woodruff, Teresa K.; Pediatrics, School of MedicineOnce unimaginable, fertility management is now a nationally established part of cancer care in institutions, from academic centers to community hospitals to private practices. Over the last two decades, advances in medicine and reproductive science have made it possible for men, women and children to be connected with an oncofertility specialist or offered fertility preservation soon after a cancer diagnosis. The Oncofertility Consortium's National Physicians Cooperative is a large-scale effort to engage physicians across disciplines - oncology, urology, obstetrics and gynecology, reproductive endocrinology, and behavioral health - in clinical and research activities to enable significant progress in providing fertility preservation options to children and adults. Here, we review the structure and function of the National Physicians Cooperative and identify next steps.Item A View from the past into our collective future: the oncofertility consortium vision statement(Springer, 2021-01) Woodruff, Teresa K.; Ataman-Millhouse, Lauren; Acharya, Kelly S.; Almeida-Santos, Teresa; Anazodo, Antoinette; Anderson, Richard A.; Appiah, Leslie; Bader, Joy; Becktell, Kerri; Brannigan, Robert E.; Breech, Lesley; Bourlon, Maria T.; Bumbuliene, Žana; Burns, Karen; Campo-Engelstein, Lisa; Campos, Jacira R.; Centola, Grace M.; Chehin, Mauricio Barbour; Chen, Diane; De Vos, Michel; Duncan, Francesca E.; El-Damen, Ahmed; Fair, Douglas; Famuyiwa, Yemi; Fechner, Patricia Y.; Fontoura, Paula; Frias, Olivia; Gerkowicz, Sabrina A.; Ginsberg, Jill; Gracia, Clarisa R.; Goldman, Kara; Gomez-Lobo, Veronica; Hazelrigg, Brent; Hsieh, Michael H.; Hoyos, Luis R.; Hoyos-Martinez, Alfonso; Jach, Robert; Jassem, Jacek; Javed, Murid; Jayasinghe, Yasmin; Jeelani, Roohi; Jeruss, Jacqueline S.; Kaul-Mahajan, Nalini; Keim-Malpass, Jessica; Ketterl, Tyler G.; Khrouf, Mohamed; Kimelman, Dana; Kusuhara, Atsuko; Kutteh, William H.; Laronda, Monica M.; Lee, Jung Ryeol; Lehmann, Vicky; Letourneau, Joseph M.; McGinnis, Lynda K.; McMahon, Eileen; Meacham, Lillian R.; Velez Mijangos, Monserrat Fabiola; Moravek, Molly; Nahata, Leena; Ogweno, George Moses; Orwig, Kyle E.; Pavone, Mary Ellen; Peccatori, Fedro Alessandro; Pesce, Romina Ileana; Pulaski, Hanna; Quinn, Gwendolyn; Quintana, Ramiro; Quintana, Tomas; de Carvalho, Bruno Ramalho; Ramsey-Goldman, Rosalind; Reinecke, Joyce; Reis, Fernando M.; Rios, Julie; Rhoton-Vlasak, Alice S.; Rodriguez-Wallberg, Kenny A.; Roeca, Cassandra; Rotz, Seth J.; Rowell, Erin; Salama, Mahmoud; Saraf, Amanda J.; Scarella, Anibal; Schafer-Kalkhoff, Tara; Schmidt, Deb; Senapati, Suneeta; Shah, Divya; Shikanov, Ariella; Shnorhavorian, Margarett; Skiles, Jodi L.; Smith, James F.; Smith, Kristin; Sobral, Fabio; Stimpert, Kyle; Su, H. Irene; Sugimoto, Kouhei; Suzuki, Nao; Thakur, Mili; Victorson, David; Viale, Luz; Vitek, Wendy; Wallace, W. Hamish; Wartella, Ellen A.; Westphal, Lynn M.; Whiteside, Stacy; Wilcox, Lea H.; Wyns, Christine; Xiao, Shuo; Xu, Jing; Zelinski, Mary; Pediatrics, School of MedicinePurpose: Today, male and female adult and pediatric cancer patients, individuals transitioning between gender identities, and other individuals facing health extending but fertility limiting treatments can look forward to a fertile future. This is, in part, due to the work of members associated with the Oncofertility Consortium. Methods: The Oncofertility Consortium is an international, interdisciplinary initiative originally designed to explore the urgent unmet need associated with the reproductive future of cancer survivors. As the strategies for fertility management were invented, developed or applied, the individuals for who the program offered hope, similarly expanded. As a community of practice, Consortium participants share information in an open and rapid manner to addresses the complex health care and quality-of-life issues of cancer, transgender and other patients. To ensure that the organization remains contemporary to the needs of the community, the field designed a fully inclusive mechanism for strategic planning and here present the findings of this process. Results: This interprofessional network of medical specialists, scientists, and scholars in the law, medical ethics, religious studies and other disciplines associated with human interventions, explore the relationships between health, disease, survivorship, treatment, gender and reproductive longevity. Conclusion: The goals are to continually integrate the best science in the service of the needs of patients and build a community of care that is ready for the challenges of the field in the future.