Gonadotropin Releasing Hormone agonist may minimize premature ovarian failure in young women undergoing autologous stem cell transplantation
Gonadotropin-releasing hormone agonist cotreatment in conjunction with conditioning chemotherapy before stem cell transplantation may significantly decrease gonadotoxicity and premature ovarian failure in lymphoma but not in leukemia patients.
Zeev Blumenfeld, M.D., Biren Patel, M.D., Ronit Leiba, M.Sc., Tsila Zuckerman, M.D.
Volume 98, Issue 5, Pages 1266-1270.e1, November 2012
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.
Prospective, nonrandomized study.
Tertiary university hospital.
Ninety-five women received conditioning chemotherapy, with or without GnRH-a before SCT. Complete information was available only for 83 patients.
Conditioning chemotherapy, with or without GnRH-a before SCT.
Main Outcome Measures:
Cyclic ovarian function (COF), or premature ovarian failure (POF) after SCT.
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 to 11.1% (4/36) for patients who did not receive GnRH-a. Patients who resumed COF were an 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.
GnRH-a cotreatment in parallel to conditioning chemotherapy before SCT may significantly decrease the gonadotoxicity and POF from 82% to 33% in lymphoma but not in leukemia patients.