Gonadal status in reproductive age women after haematopoietic stem cell transplantation for haematological malignancies.
BACKGROUND
Ovarian failure is a frequent complication occurring after haematopoietic stem cell transplantion (SCT), which is generally ascribed to radiation treatment and antiblastic alkylating agents.


METHODS
Ovarian morphology and function were studied in reproductive age women 12-24 months after allogeneic SCT (n = 23) received from an HLA identical sibling, or autologous SCT (n = 22). Thirteen allo-transplanted women were suffering from chronic graft-versus-host disease (cGVHD).


RESULTS
Menstrual cycles recovered in two and four women in the allo- and auto-SCT groups respectively, being associated with younger age and longer period elapsed from transplant. There was no difference in previous use of alkylating agents between allo- and auto-transplantation, while corticosteroid treatment was longer and more recent in the allo-SCT group. Significantly higher gonadotrophin levels and lower estradiol were seen in the combined group of patients than in controls. In allo-transplanted women, androgens were also significantly lower than in controls. Ovarian and uterine volumes were lower in patients than in controls, and in the allo- than in the auto-transplanted women. Within the allo-SCT group, endocrine function and ovarian and uterine volumes were significantly lower in the patients suffering from cGVHD.


CONCLUSIONS
Ovarian failure in SCT recipients is likely to be caused principally by myelo-ablative treatments, but the condition of gonadal and androgen insufficiency can be worsened by an altered immunomodulation in allogeneic setting.
Tauchmanovà
Libuse
L
Department of Molecular and Clinical Endocrinology and Oncology, Federico II University of Naples, via S.Pansini 5, 80131 Naples, Italy.
Selleri
Carmine
C
De Rosa
Gennaro
G
Esposito
Mariarosaria
M
Orio
Francesco
F
Palomba
Stefano
S
Bifulco
Giuseppe
G
Nappi
Carmine
C
Lombardi
Gaetano
G
Rotoli
Bruno
B
Colao
Annamaria
A
D000328:Adult; D018906:Antineoplastic Agents, Alkylating / Q000009:adverse effects; D005260:Female; D012739:Gonadal Steroid Hormones / Q000097:blood; D006062:Gonadotropins / Q000097:blood; D006086:Graft vs Host Disease / Q000150:complications*; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007938:Leukemia / Q000628:therapy*; D008597:Menstrual Cycle; D008875:Middle Aged; D006080:Ovarian Follicle / Q000502:physiology; D010865:Pilot Projects; D016649:Primary Ovarian Insufficiency / Q000000981:diagnostic imaging / Q000209:etiology* / Q000276:immunology; D011446:Prospective Studies; D014463:Ultrasonography
D018906:Antineoplastic Agents, Alkylating; D012739:Gonadal Steroid Hormones; D006062:Gonadotropins