Primary ovarian dysfunction after hematopoietic stem cell transplantation during childhood: busulfan-based conditioning is a major concern

• Published in: Journal of Pediatric Endocrinology and Metabolism Vol. 24; no. 11-12; pp. 1031 - 1035
• Main Authors: Cho, Won-Kyoung, Lee, Jae-Wook, Chung, Nak Gyun, Jung, Min Ho, Cho, Bin, Suh, Byung-Kyu, Kim, Hack Ki
• Format: Journal Article
• Language: English
• Published: Germany Walter de Gruyter 01.12.2011
• Subjects: Adolescent; busulfan; Busulfan - adverse effects; Child; Female; hematopoietic stem cell transplantation; Hematopoietic Stem Cell Transplantation - adverse effects; Humans; Leukemia, Myelogenous, Chronic, BCR-ABL Positive - epidemiology; Leukemia, Myelogenous, Chronic, BCR-ABL Positive - therapy; Leukemia, Myeloid, Acute - epidemiology; Leukemia, Myeloid, Acute - therapy; Myeloablative Agonists - adverse effects; primary ovarian insufficiency; Primary Ovarian Insufficiency - epidemiology; Primary Ovarian Insufficiency - etiology; Retrospective Studies; Risk Factors; Transplantation Conditioning - adverse effects
• ISSN: 0334-018X; 2191-0251
• DOI: 10.1515/JPEM.2011.339

We evaluated the incidence of patient/treatment factors associated with primary ovarian failure (POF) after hematopoietic stem cell transplantation (HSCT) during childhood. Fifty girls over 12 years of age (15.0±2.2) who were referred to the pediatric endocrinology clinic between March 2002 and March 2010 after HSCT at the Catholic HSCT center were enrolled in the study. In total, 36 (72%) out of 50 patients developed POF. Twenty-three patients were diagnosed and treated as chronic graft-versus-host disease. As preparative regimens for HSCT, 23 patients received total body irradiation (TBI)-based regimen, 19 received busulfan (BU)-based regimen, 4 received both BU- and TBI-based, and 4 received reduced intensity conditioning regimen. In a univariate logistic regression analysis, the BU-based regimen (p=0.028) showed a strong relationship with POF. The incidence of POF according to the route of BU administration, between orally and intravenously, were not different (p=0.435). These results emphasize the importance of monitoring these patients at regular intervals and the need to develop complementary HSCT protocols for preventing POF in children.