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Males |
Females |
| High risk |
Prolonged damage to sperm production:
- Alkylating agents (e.g., busulfan, cyclophosphamide, ifosfamide, melphelan, procarbarzine) used as conditioning treatment prior to bone marrow/stem cell transplantation
- Alkylating agents combined with pelvic, testicular, or total body irradiation
- Brain irradiation doses of 40 Gy or more
- Cyclophosphamide doses of more than 7.5 g/m2
- Total body irradiation
- Testicular radiation doses of 2.5 Gy or more (men), 6 Gy or more (boys)
|
Cessation of menstrual cycles in more than 80% of women and girls:
- Alkylating agents (e.g., busulfan, cyclophosphamide, ifosfamide, melphelan, procarbarzine) used as conditioning treatment prior to bone marrow/stem cell transplantation
- Alkylating agents combined with pelvic or total body irradiation
- Brain irradiation doses of 40 Gy or more
- Cyclophosphamide doses of more than 5 g/m2 or for six cycles in combination with other chemotherapy agents in women aged 40 or older
- Cyclophosphamide doses of more than 7.5 g/m2 in women aged under 20
- Whole abdominal or pelvic radiation doses of 6 Gy or more (adult women), 10 Gy or more (postpubertal girls), 15 Gy or more (prepubertal girls)
- Total body irradiation
|
| Intermediate risk |
Prolonged damage to sperm production uncommon at standard doses:
- Bleomycin, etoposide, and cisplatin (two to four cycles)
- Carboplatin – cumulative dose of 2 g/m2 or more
- Cisplatin – cumulative dose of more than 400 mg/ m2
- Testicular radiation doses of 1–6 Gy
|
Cessation of menstrual cycles in around 30%–70% of women and girls:
- Six cycles of cyclophosphamide in combination with other chemotherapy agents in women aged 30–39
- Cyclophosphamide plus doxorubicin in women aged 40 or older
- Spinal radiation doses of more than 25 Gy
- Whole abdominal or pelvic radiation doses of 5–10 Gy (postpubertal girls), 10–15 Gy (prepubertal girls)
|
| Low risk |
Temporary damage to sperm production:
- Multidrug regimens of nonalkylating chemotherapy agents
- Testicular radiation doses of 0.2–0.7 Gy
|
Cessation of menstrual cycles in less than 20% of women and girls:
- 6 cycles of cyclophosphamide in combination with other chemotherapy agents in women aged under 30
- Anthracycline plus cytarabine
- Cyclophosphamide plus doxorubicin in women aged 30–39
- Multidrug regimens of nonalkylating chemotherapy agents
|
| Very low/no risk |
No effects on sperm production:
- Interferon alfa
- Radioactive iodine
- Testicular radiation doses of less than 0.2 Gy
|
Little or no effect on menstrual cycle:
- Methotrexate plus fluorouracil
- Radioactive iodine
- Vincristine (in multidrug regimens)
|
| Unknown risk |
- Bevacizumab
- Cetuximab
- Erlotinib
- Imatinib
- Irinotecan
|
- Bevacizumab
- Cetuximab
- Docetaxel, paclitaxel
- Erlotinib
- Imatinib
- Irinotecan
- Oxaliplatin
- Trastuzumab
|