Ovarian function after autologous bone marrow transplantation in childhood: high-dose busulfan is a major cause of ovarian failure.
We studied pubertal status and ovarian function in 21 girls aged 11-21 years who had earlier received 1.2-13 years (median 7 years) high-dose chemotherapy and autologous BMT without TBI for malignant tumors. Ten of them were given busulfan (600 mg/m2) and melphalan (140 mg/m2) with or without cyclophosphamide (3.6 g/m2). Eleven others did not receive busulfan. Twelve girls (57%) had clinical and hormonal evidence of ovarian failure. Among nine others who had completed normal puberty, six had normal gonadotropin levels, one had elevated gonadotropin levels and two had gonadotropin levels at the upper limit of normal. The 10 girls who received busulfan all developed severe and persistent ovarian failure. High-dose busulfan is therefore a major cause of ovarian failure even when given in the prepubertal period. These findings emphasize the need for long-term endocrine follow-up of these patients in order to initiate estrogen replacement therapy.
Teinturier
C
C
Department of Pediatric Endocrinology, Hopital Saint-Vincent de Paul, Paris, France.
Hartmann
O
O
Valteau-Couanet
D
D
Benhamou
E
E
Bougneres
P F
PF
D000293:Adolescent; D000328:Adult; D018906:Antineoplastic Agents, Alkylating / Q000009:adverse effects; D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D002066:Busulfan / Q000008:administration & dosage / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D004958:Estradiol / Q000097:blood; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D007986:Luteinizing Hormone / Q000097:blood; D008558:Melphalan / Q000009:adverse effects; D009369:Neoplasms / Q000150:complications / Q000628:therapy; D010050:Ovarian Function Tests; D010053:Ovary / Q000187:drug effects / Q000503:physiopathology*; D016649:Primary Ovarian Insufficiency / Q000139:chemically induced*; D011628:Puberty, Delayed / Q000139:chemically induced; D017741:Survivors; D019172:Transplantation Conditioning; D014182:Transplantation, Autologous
D018906:Antineoplastic Agents, Alkylating; D007166:Immunosuppressive Agents; D004958:Estradiol; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone; D002066:Busulfan; D008558:Melphalan