Inducing amenorrhea during bone marrow transplantation. A pilot study of leuprolide acetate.
OBJECTIVE
To evaluate, in a pilot study, the use and efficacy of a gonadotropin-releasing hormone (GnRH)-agonist in inducing amenorrhea in women undergoing BMT.


METHODS
We evaluated the use of the GnRH agonist leuprolide acetate (LA) for the induction of amenorrhea in 10 postmenarcheal women prior to BMT. If there was a contraindication to the use of the intramuscular (i.m.) formulation of LA, the subcutaneous (s.c.) formulation was given as a daily intravenous (i.v.) bolus. Once the subject's platelet count was > 50,000/microL, the LA was discontinued. Menstrual bleeding, time from initiation of therapy to amenorrhea, and liver function test results were monitored.


RESULTS
All subjects had induction of amenorrhea with the use of LA except for one subject with a large, myomatous uterus, who experienced light spotting. One subject who was thrombocytopenic at the prescribed time of the second dosage of i.m. LA received i.v. LA with documentation of continued pituitary/gonadal suppression. No adverse effects were determined to be directly related to either the i.m. or i.v. LA.


CONCLUSIONS
LA is an option for the induction of amenorrhea in postmenarcheal women undergoing BMT. In thrombocytopenic subjects, administration of the s.c. formulation of LA by an i.v. route served as an alternative to i.m. injection and was documented to maintain gonadotropin suppression.
Laufer
M R
MR
Department of Obstetrics, Gynecology and Reproductive Biology, Brigham and Women's Hospital, Boston, MA 02115, USA.
Townsend
N L
NL
Parsons
K E
KE
Brody
K A
KA
Diller
L R
LR
Emans
S J
SJ
Guinan
E C
EC
D000293:Adolescent; D000328:Adult; D000568:Amenorrhea / Q000139:chemically induced*; D016026:Bone Marrow Transplantation / Q000379:methods*; D000075202:Contraindications; D005260:Female; D006801:Humans; D007273:Injections, Intramuscular; D007275:Injections, Intravenous; D007938:Leukemia / Q000628:therapy; D016729:Leuprolide / Q000008:administration & dosage / Q000627:therapeutic use*; D008223:Lymphoma / Q000628:therapy; D010865:Pilot Projects; D010976:Platelet Count; D014592:Uterine Hemorrhage / Q000517:prevention & control
D016729:Leuprolide