Menstrual patterns, fertility and main pregnancy outcomes after allogeneic haematopoietic stem cell transplantation
Menstrual patterns, fertility and main pregnancy outcomes after allogeneic haematopoietic stem cell transplantation
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DOI：
10.3109/01443615.2016.1154508
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发表时间：
2016-08-01
影响因子：
1.3
通讯作者：
Bacigalupo, Andrea
中科院分区：
文献类型：
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作者：
Chiodi, Sandra;Spinelli, Simonetta;Bacigalupo, Andrea
回顾性研究了269例42岁接受异基因干细胞移植的女性患者，以评估年龄、预处理方案和慢性移植物抗宿主病（cGVHD）对恢复稳定月经周期的影响。总体而言，在22%的病例中观察到稳定的月经周期。月经恢复的累积概率与年龄和预处理方案显著相关。仅在单变量分析中观察到cGVHD严重程度与月经恢复之间的统计学显著负相关。在卵巢功能残留的患者中，43%发现不孕症，45%发现早期绝经。在单次自然妊娠中观察到早产和低出生体重（LBW）的发生率增加。促卵泡激素（FSH）和17 β-雌二醇水平被发现不足以检测月经恢复和月经稳定的早期迹象。我们的研究证实了全剂量全身照射（TBI）和年龄对造血干细胞移植（HSCT）后月经恢复和生育能力的关键作用。严重cGVHD的影响仍不清楚。
Two-hundred and sixty-nine females aged42 and undergoing an allogeneic stem cell transplant were retrospectively studied to assess the effect of age, conditioning regimen and chronic graft-versus-host disease (cGVHD) on resumption of stable menstrual cyclicity. Overall, a stable menstrual cyclicity was observed in 22% of cases. The cumulative probability of menses resumption was significantly age and conditioning regimen related. A statistically significant inverse correlation between cGVHD severity and menses resumption was observed only in univariate analysis. In patients with residual ovarian function, infertility was found in 43% and early menopause in 45%. An increased incidence of prematurity and low birth weight (LBW) was observed among the single spontaneous pregnancies. Follicle-stimulating hormone (FSH) and 17 beta-oestradiol levels were found to be inadequate to detect both early signs of menses resumption and menstrual stability. Our study confirms the crucial role of full dose total body irradiation (TBI) and age on menses recovery and fertility after haematopoietic stem cell transplantation (HSCT). The impact of severe cGVHD remains unclear.