Gonadotropin-releasing hormone agonist may minimize premature ovarian failure in young women undergoing autologous stem cell transplantation
Gonadotropin-releasing hormone agonist may minimize premature ovarian failure in young women undergoing autologous stem cell transplantation
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DOI：
10.1016/j.fertnstert.2012.07.1144
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发表时间：
2012-11-01
影响因子：
6.7
通讯作者：
Zuckerman, Tsila
中科院分区：
文献类型：
--
作者：
Blumenfeld, Zeev;Patel, Biren;Zuckerman, Tsila
目的：比较年轻女性干细胞移植（SCT）后接受gnrh激动剂（GnRH-a）联合促性腺毒素化疗后卵巢早衰（POF）的发生率。设计：前瞻性、非随机研究。单位：第三大学附属医院。患者：95名女性在SCT前接受了有或没有GnRH-a的调理化疗。仅有83例患者获得完整信息。干预：SCT前调节化疗，伴或不伴GnRH-a。主要观察指标：SCT后循环卵巢功能（COF）或POF。结果：实验组与对照组在年龄、化疗治疗或诊断方面无显著差异。在GnRH-a组中，38.3%（18/47）的患者恢复了COF，而未接受GnRH-a的患者为11.1%（4/36）。恢复COF的患者在移植时比经历过POF的患者平均年轻3.7岁（中位3岁）。GnRH-a对淋巴瘤患者的长期COF有显著影响（GnRH-a组为66.7%[14/21]，对照组为18.2%[2/11]），但对白血病患者无显著影响。结论：SCT前GnRH-a联合调理化疗可显著降低淋巴瘤患者的促性腺毒性和POF，从82%降至33%，而白血病患者无此作用。[j] .中国农业科学（英文版），2012;22(1):1 -7。(C)2012年，美国生殖医学学会。)
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. (Fertil Steril (R) 2012;98:1266-70. (C)2012 by American Society for Reproductive Medicine.)