title: Gonadotropin-releasing hormone agonist may minimize premature ovarian failure in young women undergoing autologous stem cell transplantation.
abstract: OBJECTIVE
  To compare the rate of premature ovarian failure (POF) after stem cell transplantation (SCT) in young women receiving GnRH-agonist (GnRH-a) in conjunction with gonadotoxic chemotherapy.
  
  
  METHODS
  Prospective, nonrandomized study.
  
  
  METHODS
  Tertiary university hospital.
  
  
  METHODS
  Ninety-five women received conditioning chemotherapy, with or without GnRH-a before SCT. Complete information was available for only 83 patients.
  
  
  METHODS
  Conditioning chemotherapy, with or without GnRH-a before SCT.
  
  
  METHODS
  Cyclic ovarian function (COF) or POF after SCT.
  
  
  RESULTS
  There were no significant differences in age, chemotherapy treatment, or diagnoses between the study and control groups. In the GnRH-a group, 38.3% (18/47) patients resumed COF, compared with 11.1% (4/36) for patients who did not receive GnRH-a. Patients who resumed COF were on average 3.7 years (median, 3 years) younger at the time of transplantation than those who experienced POF. GnRH-a had a significant effect on long-term COF in patients with lymphomas (66.7% [14/21] for GnRH-a group vs. 18.2% [2/11] for control) but not for leukemia patients.
  
  
  CONCLUSIONS
  GnRH-a cotreatment in conjunction with conditioning chemotherapy before SCT may significantly decrease the gonadotoxicity and POF from 82% to 33% in lymphoma but not in leukemia patients.
authors.affiliation: Reproductive Endocrinology and Bone Marrow Transplantation Units, RAMBAM Health Care Campus, Rappaport Institute and Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel. bzeev@techunix.technion.ac.il
authors.forename: Zeev
authors.initials: Z
authors.lastname: Blumenfeld
authors.forename: Biren
authors.initials: B
authors.lastname: Patel
authors.forename: Ronit
authors.initials: R
authors.lastname: Leiba
authors.forename: Tsila
authors.initials: T
authors.lastname: Zuckerman
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D005260:Female; D005300:Fertility Agents, Female / Q000627:therapeutic use*; D059247:Fertility Preservation / Q000379:methods*; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists* / Q000378:metabolism; D006801:Humans; D007557:Israel; D007938:Leukemia / Q000401:mortality / Q000628:therapy; D008223:Lymphoma / Q000401:mortality / Q000628:therapy; D010053:Ovary / Q000187:drug effects* / Q000378:metabolism / Q000503:physiopathology; D016649:Primary Ovarian Insufficiency / Q000209:etiology / Q000378:metabolism / Q000503:physiopathology / Q000517:prevention & control*; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D033581:Stem Cell Transplantation / Q000009:adverse effects*; D013997:Time Factors; D019172:Transplantation Conditioning / Q000009:adverse effects*; D016896:Treatment Outcome; D017329:Triptorelin Pamoate / Q000627:therapeutic use*
chemical_list: D005300:Fertility Agents, Female; D017329:Triptorelin Pamoate; D007987:Gonadotropin-Releasing Hormone