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Ovarian function after hematopoietic cell transplantation: a descriptive study following the use of GnRH agonists for myeloablative conditioning and observation only for reduced-intensity conditioning. Bone Marrow Transplant 2016 Oct;51(10):1369-1375

Date

06/09/2016

Pubmed ID

27272448

Pubmed Central ID

PMC5299542

DOI

10.1038/bmt.2016.150

Scopus ID

2-s2.0-84976288626   13 Citations

Abstract

Gonadal failure is a health and quality-of-life concern in hematopoietic cell transplant (HCT) survivors. While ovarian dysfunction is nearly universal following myeloablative (MA) conditioning, the risk is unclear after reduced-intensity conditioning (RIC). Gonadotropin-releasing hormone agonists decrease ovarian failure rates following conventional chemotherapy, but little is known about its effectiveness with HCT. We investigated the impact of leuprolide on ovarian function after MA conditioning and monitored ovarian function after RIC in this descriptive pilot study. Post-menarchal females <50 years undergoing HCT with adequate baseline ovarian function (follicle-stimulating hormone (FSH) level <40 mIU/mL and normal menstruation) were eligible. Prior to MA conditioning, leuprolide was administered. Those undergoing RIC were observed. FSH was measured at various time points. Seventeen women aged 12-45 years were evaluated (7 in the intervention group and 10 in the observation group). Compared to the historical high rate of ovarian failure after MA conditioning, 3 of 7 evaluable Lupron recipients had ovarian failure at a median of 703 days post transplant. Ovarian failure occurred in 1 of 10 recipients of RIC at a median follow-up of 901 days. In conclusion, leuprolide may protect ovarian function after MA conditioning. Additionally, RIC with cyclophosphamide, fludarabine and low-dose TBI has a low risk of ovarian failure.

Author List

Phelan R, Mann E, Napurski C, DeFor TE, Petryk A, Miller WP, Wagner JE, Verneris MR, Smith AR

Author

Rachel A. Phelan MD Assistant Professor in the Pediatrics department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Adolescent
Adult
Child
Female
Follicle Stimulating Hormone
Gonadotropin-Releasing Hormone
Hematopoietic Stem Cell Transplantation
Humans
Leuprolide
Middle Aged
Myeloablative Agonists
Ovarian Function Tests
Ovary
Pilot Projects
Transplantation Conditioning
Young Adult