Hormone replacement therapy and chronic graft-versus-host disease activity in women treated with bone marrow transplantation for hematologic malignancies.
Several lines of experimental evidence suggest that sex hormones may influence the development and activity of chronic graft-versus-host disease (cGVHD), which frequently occurs in patients undergoing allogeneic bone marrow transplantation (ABMT). Following ABMT, young women are commonly treated with hormone replacement therapy (HRT) because of irreversible gonadal failure. It seemed therefore worthwhile to investigate the effects of this therapy on the activity of cGVHD. Premenopausal women treated with ABMT for hematological malignancies between January 1997 and December 2000 were evaluated for cGVHD activity. They were divided into two groups, depending on whether or not they were treated with HRT. Seventy-one women qualified for the present study: 39 received HRT (treated group), while 32 did not (controls). In both groups of patients, cGVHD activity score was comparable before the start of HRT. No differences were observed in cGVHD activity score between the HRT group and controls after 3, 6, 12, and 24 months from the start of HRT. Furthermore, HRT did not induce any increase in the cGVHD activity score in the treated group of patients at any time from the start of HRT. According to present data, HRT did not appear to influence the activity of cGVHD in young women who underwent ABMT for hematological malignancies. Therefore, we can safely propose this therapy for women with gonadal failure after ABMT.
Department of Internal Medicine, University of Genova and San Martino Hospital, 16132 Genoa, Italy. balleari@unige.it
Enrico
E
Balleari
Simona
S
Garre
Maria Teresa
MT
Van Lint
Simonetta
S
Spinelli
Sandra
S
Chiodi
Enrico
E
Repetto
Giulio
G
Massa
Andrea
A
Bacigalupo
Riccardo
R
Ghio
D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D015914:Estrogen Replacement Therapy / Q000009:adverse effects; D005260:Female; D006086:Graft vs Host Disease / Q000209:etiology; D019337:Hematologic Neoplasms / Q000628:therapy*; D006801:Humans; D008875:Middle Aged; D016649:Primary Ovarian Insufficiency / Q000188:drug therapy* / Q000209:etiology; D012189:Retrospective Studies; D012449:Safety; D012720:Severity of Illness Index; D019172:Transplantation Conditioning / Q000009:adverse effects; D014184:Transplantation, Homologous / Q000009:adverse effects; D014916:Whole-Body Irradiation / Q000009:adverse effects