[Premature ovarian failure in patients affected by oncohematological disease].
OBJECTIVE
Premature ovarian failure (POF) can be considered a consequence of chemotherapy performed in patients affected by oncohematological disease. The aim of this study was to evaluate the administration of GnRh analogs (aGnRh) to prevent gonadal toxicity associated with cancer treatment.


METHODS
From April 1996 to May 2002 a total of 49 fertile women affected by oncohematological diseases (Hodgkin's lymphoma, non-Hodgkin's lymphoma, acute leukemia) and treated with chemotherapy were evaluated. Ovarian function was studied through a 40.7 month observation period, after chemotherapy, in 3 different groups: women treated with aGnRh, oral contraceptives treatment and no preventive-treatment. The differences in these groups as to menstrual cycle, blood ovarian hormones, age at diagnosis, type and dosage of chemotherapy administered were evaluated. Statistical analysis was performed by chi2 test with Yates correction and Fisher test.


RESULTS
All patients treated with aGnRh and chemotherapy achieved a good ovarian function. A normal ovarian function was also obtained in 75% of patients treated with oral contraceptives and only in 59.3% of women with no preventive treatment. Significant difference was found comparing aGnRh group with no preventive-treatment group (P<0.05). No significant differences were found between other groups.


CONCLUSIONS
Use of GnRh analogs administered before beginning chemotherapy prevents from gonadal damage in all cases observed. Higher chemotherapy toxicity and older age at diagnosis time decrease ovarian function.
Marchesoni
D
D
Dipartimento di Scienze Chirurgiche, Clinica di Ostetricia e Ginecologia, Università degli Studi di Udine, Udine, Italy. diego.marchesoni@dsc.uniud.it
Driul
L
L
Fruscalzo
A
A
Santuz
M
M
Calcagno
A
A
Ianni
A
A
Geromin
A
A
Fanin
R
R
D000293:Adolescent; D000328:Adult; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use; D003276:Contraceptives, Oral / Q000627:therapeutic use; D005260:Female; D007987:Gonadotropin-Releasing Hormone / Q000031:analogs & derivatives; D019337:Hematologic Neoplasms / Q000188:drug therapy; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D016649:Primary Ovarian Insufficiency / Q000139:chemically induced* / Q000517:prevention & control*; D011446:Prospective Studies; D017329:Triptorelin Pamoate / Q000627:therapeutic use
D000970:Antineoplastic Agents; D018931:Antineoplastic Agents, Hormonal; D003276:Contraceptives, Oral; D017329:Triptorelin Pamoate; D007987:Gonadotropin-Releasing Hormone