title: Adolescent and adult uterine volume and uterine artery Doppler blood flow among subjects treated with bone marrow transplantation or chemotherapy in pediatric age: a case-control study.
abstract: OBJECTIVE
  To compare uterine and ovarian volumes and uterine artery (UA) Doppler blood flow among women who were treated with antineoplastic regimens when pediatric aged versus healthy controls.
  
  
  METHODS
  Case-control study.
  
  
  METHODS
  Tertiary obstetric and gynecologic center.
  
  
  METHODS
  One hundred twenty-seven women who were treated for childhood cancer with bone marrow transplantation (BMT) and∖or chemotherapy and total body irradiation (TBI) and 64 age-matched healthy controls.
  
  
  METHODS
  Ultrasonographic and clinical evaluations.
  
  
  METHODS
  Uterine and ovarian volume, detection of follicles, and UA pulsatility index (PI).
  
  
  RESULTS
  Median uterus and ovarian volumes were reduced by 64% (95% CI, 56.6-70.6) and 83.6% (95% CI, 79.6-86.7), respectively, among cases compared with controls. Median UA PI among cases was increased by 30.3% (95% CI, 19.6-40.8) compared with controls. Ovarian follicles were identified in 24 (18.9%) of 127 cases and 25 (39%) of 64 controls. Uterine volume was reduced after TBI (percent reduction 81.9%; 95% CI, 71.8-87.8) or busulfan (percentage reduction 67.4%; 95% CI, 58.5-75.6) compared with those who had not received a conditioning regimen (percentage reduction 24.4%; 95% CI, 7.6-38.2). The only factors independently associated with reduced uterine and ovarian volumes compared with controls were TBI, busulfan, and BMT. The worst effect on UA PI resulted from BMT and a diagnosis of hematologic disease.
  
  
  CONCLUSIONS
  Bone marrow transplantation as main treatment and TBI and busulfan as conditioning regimens had the worst effect on uterine and ovarian sizes compared with controls. These data should be considered in counseling families on preserving future fertility in children undergoing BMT.
authors.affiliation: Department of Obstetrics and Gynecology, IRCCS S. Matteo Hospital, Pavia, Italy.
authors.forename: Fausta
authors.initials: F
authors.lastname: Beneventi
authors.affiliation: Department of Obstetrics and Gynecology, IRCCS S. Matteo Hospital, Pavia, Italy. Electronic address: elena.loc@libero.it.
authors.forename: Elena
authors.initials: E
authors.lastname: Locatelli
authors.affiliation: Pediatric Oncohematology Unit, IRCCS S. Matteo Hospital, Pavia, Italy.
authors.forename: Giovanna
authors.initials: G
authors.lastname: Giorgiani
authors.affiliation: Pediatric Oncohematology Unit, IRCCS S. Matteo Hospital, Pavia, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Zecca
authors.affiliation: Pediatric Oncohematology Unit, IRCCS S. Matteo Hospital, Pavia, Italy.
authors.forename: Tommaso
authors.initials: T
authors.lastname: Mina
authors.affiliation: Department of Obstetrics and Gynecology, IRCCS S. Matteo Hospital, Pavia, Italy.
authors.forename: Margherita
authors.initials: M
authors.lastname: Simonetta
authors.affiliation: Department of Obstetrics and Gynecology, IRCCS S. Matteo Hospital, Pavia, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Cavagnoli
authors.affiliation: Department of Obstetrics and Gynecology, IRCCS S. Matteo Hospital, Pavia, Italy.
authors.forename: Mara
authors.initials: M
authors.lastname: Albanese
authors.affiliation: Department of Obstetrics and Gynecology, IRCCS S. Matteo Hospital, Pavia, Italy.
authors.forename: Arsenio
authors.initials: A
authors.lastname: Spinillo
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000970:Antineoplastic Agents / Q000009:adverse effects*; D001783:Blood Flow Velocity / Q000187:drug effects / Q000502:physiology*; D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D002066:Busulfan / Q000009:adverse effects; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D009929:Organ Size / Q000187:drug effects; D016896:Treatment Outcome; D018615:Ultrasonography, Doppler, Color / Q000379:methods; D018617:Ultrasonography, Doppler, Pulsed / Q000379:methods; D055988:Uterine Artery / Q000000981:diagnostic imaging* / Q000187:drug effects; D014599:Uterus / Q000098:blood supply / Q000000981:diagnostic imaging* / Q000187:drug effects; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents; D002066:Busulfan
keywords: Bone marrow transplantation; chemotherapy; total body irradiation; uterine artery; uterine volume