title: The effects of hydroxyurea and bone marrow transplant on Anti-Müllerian hormone (AMH) levels in females with sickle cell anemia.
abstract: Gonadal hypofunction is described in male and female patients with sickle cell anemia (SCA) after bone marrow transplant (BMT) and in males treated with hydroxyurea (HU). Anti-Müllerian hormone (AMH) is a serum marker of ovarian reserve. This study describes AMH and follicle-stimulating hormone (FSH) levels in female SCA subjects treated with supportive care (SCA-SC), HU (SCA-HU) and BMT (SCA-BMT). SCA (SS/Sβ(0)) subjects not on HU, on HU and status-post BMT, ages 10-21 years were recruited. SCA-HU subjects were treated with HU ≥ 20 mg/kg for ≥ 12 consecutive months. SCA-BMT subjects had received busulfan and cyclophosphamide. Serum AMH and random FSH levels were obtained. Diminished ovarian reserve (DOR) was defined as AMH level <5th percentile for age-matched controls. Subjects also with FSH >40 IU/L were classified as having premature ovarian insufficiency (POI). 14 SCA-SC (14.5 ± 2.7 years), 33 SCA-HU (14.4 ± 2.4 years) and 9 SCA-BMT (14.3 ± 2.7 years) females were included. AMH was undetectable in all SCA-BMT subjects and <5th percentile in 24% of SCA-HU subjects. FSH was menopausal (>40 IU/L) in 88.9% of SCA-BMT subjects. All SCA-BMT subjects and 24% of subjects on HU had DOR; 89% of SCA-BMT subjects had POI. AMH and FSH may be useful tools in assessing ovarian reserve and function.
authors.affiliation: Emory University School of Medicine, Department of Pediatrics, Division of Endocrinology and Metabolism, 2015 Uppergate Drive, NE Atlanta, GA 30322, USA. Electronic address: selchur@emory.edu.
authors.forename: Swati V
authors.initials: SV
authors.lastname: Elchuri
authors.affiliation: Division of Hematology/Oncology/BMT and Aflac Cancer and Blood Disorders Center of Children's Healthcare of Atlanta, 2015 Uppergate Drive, NE Atlanta, GA 30322, USA.
authors.forename: Rebecca S
authors.initials: RS
authors.lastname: Williamson
authors.affiliation: Division of Hematology/Oncology/BMT and Aflac Cancer and Blood Disorders Center of Children's Healthcare of Atlanta, 2015 Uppergate Drive, NE Atlanta, GA 30322, USA.
authors.forename: R
authors.initials: R
authors.lastname: Clark Brown
authors.affiliation: Division of Hematology/Oncology/BMT and Aflac Cancer and Blood Disorders Center of Children's Healthcare of Atlanta, 2015 Uppergate Drive, NE Atlanta, GA 30322, USA.
authors.forename: Ann E
authors.initials: AE
authors.lastname: Haight
authors.affiliation: Department of Gynecology and Obstetrics, Division of Reproductive Endocrinology and Infertility, Medical Office Tower Suite 1800, 550 Peachtree Street, NE Atlanta, GA 30308, USA.
authors.forename: Jessica B
authors.initials: JB
authors.lastname: Spencer
authors.affiliation: Division of Hematology/Oncology/BMT and Aflac Cancer and Blood Disorders Center of Children's Healthcare of Atlanta, 2015 Uppergate Drive, NE Atlanta, GA 30322, USA; Morehouse Healthcare of the Morehouse School of Medicine, 75 Piedmont Avenue Northeast #700, Atlanta, GA 30303, USA.
authors.forename: Iris
authors.initials: I
authors.lastname: Buchanan
authors.affiliation: Division of Hematology/Oncology/BMT and Aflac Cancer and Blood Disorders Center of Children's Healthcare of Atlanta, 2015 Uppergate Drive, NE Atlanta, GA 30322, USA.
authors.forename: Leann
authors.initials: L
authors.lastname: Hassen-Schilling
authors.affiliation: Emory University School of Medicine, Department of Pediatrics, Division of Endocrinology and Metabolism, 2015 Uppergate Drive, NE Atlanta, GA 30322, USA.
authors.forename: Milton R
authors.initials: MR
authors.lastname: Brown
authors.affiliation: Division of Hematology/Oncology/BMT and Aflac Cancer and Blood Disorders Center of Children's Healthcare of Atlanta, 2015 Uppergate Drive, NE Atlanta, GA 30322, USA.
authors.forename: Ann C
authors.initials: AC
authors.lastname: Mertens
authors.affiliation: Emory University School of Medicine, Department of Pediatrics, Division of Endocrinology and Metabolism, 2015 Uppergate Drive, NE Atlanta, GA 30322, USA; Division of Hematology/Oncology/BMT and Aflac Cancer and Blood Disorders Center of Children's Healthcare of Atlanta, 2015 Uppergate Drive, NE Atlanta, GA 30322, USA.
authors.forename: Lillian R
authors.initials: LR
authors.lastname: Meacham
mesh_terms: D000293:Adolescent; D000755:Anemia, Sickle Cell / Q000097:blood / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D054304:Anti-Mullerian Hormone / Q000097:blood*; D000986:Antisickling Agents / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood; D016026:Bone Marrow Transplantation; D002066:Busulfan / Q000627:therapeutic use; D016022:Case-Control Studies; D002648:Child; D003520:Cyclophosphamide / Q000627:therapeutic use; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D006451:Hemoglobin, Sickle / Q000378:metabolism; D006579:Heterozygote; D006720:Homozygote; D006801:Humans; D006918:Hydroxyurea / Q000627:therapeutic use*; D008572:Menarche / Q000502:physiology; D019653:Myeloablative Agonists / Q000627:therapeutic use; D065851:Ovarian Reserve / Q000187:drug effects; D016649:Primary Ovarian Insufficiency / Q000097:blood / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D055815:Young Adult
chemical_list: D000986:Antisickling Agents; D015415:Biomarkers; D006451:Hemoglobin, Sickle; D019653:Myeloablative Agonists; D054304:Anti-Mullerian Hormone; D003520:Cyclophosphamide; D005640:Follicle Stimulating Hormone; D002066:Busulfan; D006918:Hydroxyurea
keywords: Anti-Müllerian hormone; Bone marrow transplant; Diminished ovarian reserve; Hydroxyurea; Premature ovarian insufficiency