Acute Onset of Ovarian Dysfunction in Young Females After Start of Cancer Treatment
Acute Onset of Ovarian Dysfunction in Young Females After Start of Cancer Treatment
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DOI：
10.1002/pbc.24327
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发表时间：
2013-04-01
影响因子：
3.2
通讯作者：
Ora, Ingrid
中科院分区：
文献类型：
--
作者：
Morse, Helena;Elfving, Maria;Ora, Ingrid
背景女性儿童癌症幸存者有卵巢衰竭和卵巢功能不全的风险。在此，我们提出了一个中期分析的前瞻性观察研究卵巢功能在癌症治疗的年轻女性的临床因素。Procedure.在知情同意后，纳入了34例连续的0-18岁女性癌症患者。在诊断时以及治疗期间和治疗后每3-4个月测量血清/血浆抗苗勒管激素（AMH）、卵泡刺激素（B）、FSH、LH和雌二醇（E2）水平。结果所有患者在诊断时均检测到AMH水平。11例患者达到月经初潮（平均年龄14 1/2岁），其余患者的平均年龄为6 1/2岁。他们在治疗3个月后都表现出AMH的快速下降，无论诊断时的AMH，年龄，月经初潮或给予治疗。接受膈下放射治疗和/或干细胞移植（SCT）的患者（n = 9）在治疗期间或治疗后1年半没有卵巢恢复。然而，在维持化疗期间接受标准治疗的急性淋巴细胞白血病患者（n = 7）中观察到恢复。对于其余患者，需要更长时间的随访以分析治疗后卵巢恢复情况。结论.在开始癌症治疗后，在所有女性中观察到快速的卵巢功能障碍，如通过AMH和抗精子抗体B测量的。我们关于需要腹部放疗和/或SCT的患者的数据证实了北欧国家的建议，这些患者在开始癌症治疗前有资格进行卵巢皮质组织冷冻保存。儿科血液癌症2013;60：676-681。(C)2012 Wiley Periodicals，Inc.
Background. Female childhood cancer survivors are at risk of ovarian failure and premature ovarian insufficiency. We hereby present an interim analysis of a prospective observational study of ovarian function during cancer treatment of young females in relation to clinical factors. Procedure. Thirty-four consecutive female cancer patients aged 0-18 year were included after informed consent. Serum/Plasma levels of anti-Mullerian hormone (AMH), inhibin B, FSH, LH, and oestradiol (E2) were measured at diagnosis and every 3-4 months during and after treatment. Results. All patients had detectable AMH levels at diagnosis. Eleven patients had reached menarche (mean age 14 1/2 years) and the remaining patients had a mean age of 6 1/2 years. They all showed a rapid decline in AMH after 3 months of treatment, regardless of AMH at diagnosis, age, menarche, or treatment given. Those given radiotherapy below the diaphragm and/or stem cell transplantation (SCT) (n = 9) had no ovarian recovery during or 1 1/2-year after treatment. However, recovery was observed in those given standard treatment for acute lymphatic leukemia (n = 7) already during maintenance chemotherapy. For the remaining patients, longer follow-up is required for analysis of ovarian recovery after treatment. Conclusions. Rapid ovarian dysfunction is observed in all females after initiation of cancer treatment as measured by AMH and inhibin B. Our data regarding those who require abdominal radiotherapy and/or SCT confirms the recommendations in the Nordic countries where these patients are eligible for cryopreservation of ovarian cortical tissue before start of cancer treatment. Pediatr Blood Cancer 2013;60:676-681. (C) 2012 Wiley Periodicals, Inc.