Gonadotropin-releasing hormone agonist may minimize premature ovarian failure in young women undergoing autologous stem cell transplantation

• Published in: Fertility and sterility Vol. 98; no. 5; pp. 1266 - 1270.e1
• Main Authors: Blumenfeld, Zeev, M.D, Patel, Biren, M.D, Leiba, Ronit, M.Sc, Zuckerman, Tsila, M.D
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.11.2012; Elsevier
• Subjects: Adult; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Bone marrow, stem cells transplantation. Graft versus host reaction; Case-Control Studies; Chi-Square Distribution; Diseases of mother, fetus and pregnancy; Female; Fertility Agents, Female - therapeutic use; Fertility preservation; Fertility Preservation - methods; GnRH-agonist; gonadotoxicity; Gonadotropin-Releasing Hormone - agonists; Gonadotropin-Releasing Hormone - metabolism; Gynecology. Andrology. Obstetrics; Humans; Internal Medicine; Israel; Leukemia - mortality; Leukemia - therapy; Lymphoma - mortality; Lymphoma - therapy; Medical sciences; Obstetrics and Gynecology; Ovary - drug effects; Ovary - metabolism; Ovary - physiopathology; Pregnancy. Fetus. Placenta; premature ovarian failure (POF); Primary Ovarian Insufficiency - etiology; Primary Ovarian Insufficiency - metabolism; Primary Ovarian Insufficiency - physiopathology; Primary Ovarian Insufficiency - prevention & control; Prospective Studies; Risk Assessment; Risk Factors; stem cell transplantation (SCT); Stem Cell Transplantation - adverse effects; Time Factors; Transfusions. Complications. Transfusion reactions. Cell and gene therapy; Transplantation Conditioning - adverse effects; Treatment Outcome; Triptorelin Pamoate - therapeutic use; Israel; gonadotoxicity; Fertility preservation; premature ovarian failure (POF); GnRH-agonist; stem cell transplantation (SCT); Endocrinopathy; Human; Premature; Agonist; Preservation; Gynecology; Gonadotropin RH; Stem cell transplantation; Obstetrics; Female genital diseases; Ovarian diseases; Autograft; Ovarian failure; Fertility; Female; Woman
• ISSN: 0015-0282; 1556-5653
• DOI: 10.1016/j.fertnstert.2012.07.1144

Objective To compare the rate of premature ovarian failure (POF) after stem cell transplantation (SCT) in young women receiving GnRH-agonist (GnRH-a) in conjunction with gonadotoxic chemotherapy. Design Prospective, nonrandomized study. Setting Tertiary university hospital. Patient(s) Ninety-five women received conditioning chemotherapy, with or without GnRH-a before SCT. Complete information was available for only 83 patients. Intervention(s) Conditioning chemotherapy, with or without GnRH-a before SCT. Main Outcome Measure(s) Cyclic ovarian function (COF) or POF after SCT. Result(s) There were no significant differences in age, chemotherapy treatment, or diagnoses between the study and control groups. In the GnRH-a group, 38.3% (18/47) patients resumed COF, compared with 11.1% (4/36) for patients who did not receive GnRH-a. Patients who resumed COF were on average 3.7 years (median, 3 years) younger at the time of transplantation than those who experienced POF. GnRH-a had a significant effect on long-term COF in patients with lymphomas (66.7% [14/21] for GnRH-a group vs. 18.2% [2/11] for control) but not for leukemia patients. Conclusion(s) GnRH-a cotreatment in conjunction with conditioning chemotherapy before SCT may significantly decrease the gonadotoxicity and POF from 82% to 33% in lymphoma but not in leukemia patients.