Absence of a dose-response effect of leuprolide acetate on leiomyomata uteri size.
OBJECTIVE
To evaluate the effects of two different doses (3.75 mg versus 7.5 mg) of leuprolide acetate (LA, Lupron; Tap Pharmaceuticals, Deerfield, IL) on myoma size, blood loss during myomectomy, on magnetic resonance imaging (MRI) signal quality, and histopathologic changes in women requiring myomectomy.


METHODS
Prospective, nonrandomized, sequential study.


METHODS
Urban center teaching hospital.


METHODS
Twenty-eight women with uterine leiomyomata requiring myomectomy.


METHODS
Nine women were entered as controls (group 1), 10 women received 3.75 mg IM (group 2), and 9 women received 7.5 mg IM of LA (group 3) each for 3 months before myomectomy.


RESULTS
The uterine size and hematocrit among the three groups of patients before treatment was not significantly different. A significant reduction of 34.5% and 34.6% in myomata size was seen in groups 2 and 3. The estimated average blood loss at myomectomy was 745 +/- 101 mL, 615 +/- 177 mL, and 722 +/- 192 mL in groups 1, 2, and 3, respectively. The postoperative hematocrit was not different among the three groups (29.8% +/- 0.9%, 30.4% +/- 1.6%, and 29.8% +/- 1.2%). There was no evidence of cytologic atypia, increased mitosis, or change in fibrosis in LA-treated women. There were no characteristic MRI or histologic changes seen after LA treatment as compared with controls.


CONCLUSIONS
The results of this study have demonstrated that both doses of LA (3.75 and 7.5 mg) can induce a significant and similar degree of size reduction in myomas and that neither dose of LA aided in the reduction of blood loss at myomectomy and therefore should not be used routinely.
Kiltz
R J
RJ
Harbor-University of California, Los Angeles Medical Center, Torrance.
Rutgers
J
J
Phillips
J
J
Murugesapillai
M L
ML
Kletzky
O A
OA
D000328:Adult; D004305:Dose-Response Relationship, Drug; D005260:Female; D006400:Hematocrit; D006801:Humans; D007889:Leiomyoma / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery; D016729:Leuprolide / Q000494:pharmacology* / Q000627:therapeutic use; D008279:Magnetic Resonance Imaging; D011446:Prospective Studies; D014594:Uterine Neoplasms / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery; D014599:Uterus / Q000187:drug effects / Q000473:pathology*
D016729:Leuprolide