Successful pregnancies in women following single autotransplant for acute myeloid leukemia with a chemotherapy ablation protocol.
Of 30 women surviving a minimum of 18 months following treatment for AML with a high-dose chemotherapy regimen with autologous bone marrow transplantation (ABMT), 24 were premenopausal at the time of transplantation. All were given a detailed questionnaire concerning menstruation, menopausal symptoms and pregnancy; 22 responded. Of these 22, 10 had received a single transplant procedure and 12 a double transplant procedure. In the 10 recipients of a single transplant, 4 women (age range 32-50 years) developed ovarian failure and 6 (age range 21-32 years) resumed spontaneous cyclical menstruation. Five of the 6 menstruating women became pregnant between 4 and 40 months following ABMT. Three pregnancies went to term and each resulted in the delivery of a full-term apparently normal infant. Of the 12 women who received a double ABMT (age range 32-47 years), 11 developed clinical and/or biochemical evidence of ovarian failure. The median age in the latter group was 35 years, however, compared with 28 years in the single ABMT group. These data show that it is possible to give a single very high-dose course of chemotherapy in younger patients without compromising fertility.
University College Hospital, London, UK.
N
N
Salooja
R
R
Chatterjee
A K
AK
McMillan
S M
SM
Kelsey
A C
AC
Newland
D W
DW
Milligan
I M
IM
Franklin
R M
RM
Hutchinson
D C
DC
Linch
A H
AH
Goldstone
D000028:Abortion, Induced; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D016026:Bone Marrow Transplantation; D002330:Carmustine / Q000008:administration & dosage / Q000009:adverse effects; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000009:adverse effects; D003561:Cytarabine / Q000008:administration & dosage / Q000009:adverse effects; D003630:Daunorubicin / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D006801:Humans; D007247:Infertility, Female / Q000139:chemically induced / Q000517:prevention & control; D007951:Leukemia, Myeloid / Q000188:drug therapy / Q000401:mortality / Q000628:therapy*; D008598:Menstruation / Q000187:drug effects; D008875:Middle Aged; D011247:Pregnancy; D011256:Pregnancy Outcome; D016649:Primary Ovarian Insufficiency / Q000139:chemically induced; D012074:Remission Induction; D012086:Reoperation; D017741:Survivors; D013866:Thioguanine / Q000008:administration & dosage / Q000009:adverse effects; D014182:Transplantation, Autologous
D003561:Cytarabine; D003520:Cyclophosphamide; D013866:Thioguanine; D002330:Carmustine; D003630:Daunorubicin