title: Gonadotropin-releasing hormone agonist for the prevention of chemotherapy-induced ovarian failure in patients with lymphoma: 1-year follow-up of a prospective randomized trial.
abstract: OBJECTIVE
  To assess the efficacy of gonadotropin-releasing hormone agonist (GnRHa) in preventing chemotherapy-induced ovarian failure in patients treated for Hodgkin or non-Hodgkin lymphoma within the setting of a multicenter, randomized, prospective trial.
  
  
  METHODS
  Patients age 18 to 45 years were randomly assigned to receive either the GnRHa triptorelin plus norethisterone (GnRHa group) or norethisterone alone (control group) concomitantly with alkylating agents containing chemotherapy. The primary end point was the premature ovarian failure (POF) rate (follicle-stimulating hormone [FSH] ≥ 40 IU/L) after 1 year of follow-up.
  
  
  RESULTS
  Eighty-four of 129 randomly assigned patients completed the 1-year follow-up. The mean FSH values were higher in the control group than in the GnRHa group during chemotherapy; however, this difference was no longer observed after 6 months of follow-up. After 1 year, 20% and 19% of patients in the GnRHa and control groups, respectively, exhibited POF (P = 1.00). More than half of patients in each group completely restored their ovarian function (FSH < 10 IU/L), but the anti-Müllerian hormone values were higher in the GnRHa group than in the control group (1.4 ± 0.35 v 0.5 ± 0.15 ng/mL, respectively; P = .040). The occurrence of adverse events was similar in both groups with the exception of metrorrhagia, which was more frequently observed in the control group than the GnRHa group (38.4% v 15.6%, respectively; P = .024).
  
  
  CONCLUSIONS
  Approximately 20% of patients in both groups exhibited POF after 1 year of follow-up. Triptorelin was not associated with a significant decreased risk of POF in young patients treated for lymphoma but may provide protection of the ovarian reserve.
authors.affiliation: Universite´ Libre de Bruxelles, Belgium. idemeest@ulb.ac.be
authors.forename: Isabelle
authors.initials: I
authors.lastname: Demeestere
authors.forename: Pauline
authors.initials: P
authors.lastname: Brice
authors.forename: Fedro A
authors.initials: FA
authors.lastname: Peccatori
authors.forename: Alain
authors.initials: A
authors.lastname: Kentos
authors.forename: Isabelle
authors.initials: I
authors.lastname: Gaillard
authors.forename: Pierre
authors.initials: P
authors.lastname: Zachee
authors.forename: Rene-Olivier
authors.initials: RO
authors.lastname: Casasnovas
authors.forename: Eric
authors.initials: E
authors.lastname: Van Den Neste
authors.forename: Julie
authors.initials: J
authors.lastname: Dechene
authors.forename: Vivianne
authors.initials: V
authors.lastname: De Maertelaer
authors.forename: Dominique
authors.initials: D
authors.lastname: Bron
authors.forename: Yvon
authors.initials: Y
authors.lastname: Englert
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects*; D015415:Biomarkers / Q000097:blood; D004359:Drug Therapy, Combination; D004958:Estradiol / Q000097:blood*; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood*; D005500:Follow-Up Studies; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists*; D006689:Hodgkin Disease / Q000188:drug therapy; D006801:Humans; D008186:Luteolytic Agents / Q000627:therapeutic use; D008223:Lymphoma / Q000188:drug therapy*; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy; D008875:Middle Aged; D009640:Norethindrone / Q000627:therapeutic use; D017697:Premenopause; D016649:Primary Ovarian Insufficiency / Q000097:blood / Q000139:chemically induced* / Q000517:prevention & control*; D011446:Prospective Studies; D013997:Time Factors; D017211:Treatment Failure; D017329:Triptorelin Pamoate / Q000627:therapeutic use*
chemical_list: D015415:Biomarkers; D008186:Luteolytic Agents; D017329:Triptorelin Pamoate; D007987:Gonadotropin-Releasing Hormone; D004958:Estradiol; D005640:Follicle Stimulating Hormone; D009640:Norethindrone