title: Gonadal status in reproductive age women after haematopoietic stem cell transplantation for haematological malignancies.
abstract: 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.
authors.affiliation: Department of Molecular and Clinical Endocrinology and Oncology, Federico II University of Naples, via S.Pansini 5, 80131 Naples, Italy.
authors.forename: Libuse
authors.initials: L
authors.lastname: Tauchmanovà
authors.forename: Carmine
authors.initials: C
authors.lastname: Selleri
authors.forename: Gennaro
authors.initials: G
authors.lastname: De Rosa
authors.forename: Mariarosaria
authors.initials: M
authors.lastname: Esposito
authors.forename: Francesco
authors.initials: F
authors.lastname: Orio
authors.forename: Stefano
authors.initials: S
authors.lastname: Palomba
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Bifulco
authors.forename: Carmine
authors.initials: C
authors.lastname: Nappi
authors.forename: Gaetano
authors.initials: G
authors.lastname: Lombardi
authors.forename: Bruno
authors.initials: B
authors.lastname: Rotoli
authors.forename: Annamaria
authors.initials: A
authors.lastname: Colao
mesh_terms: 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
chemical_list: D018906:Antineoplastic Agents, Alkylating; D012739:Gonadal Steroid Hormones; D006062:Gonadotropins