title: Fertility in premenopausal women post autologous stem cell transplant with BEAM conditioning.
abstract: There is currently minimal data on fertility outcomes in premenopausal women undergoing autologous stem cell transplant (ASCT) with carmustine, etoposide, cytarabine and melphalan (BEAM) conditioning. A retrospective analysis of fertility outcomes in premenopausal females aged between 18 and 40 yr who underwent BEAM/ASCT for lymphoma between 1995 and 2011 was performed at four transplant centres. Of 41 premenopausal women who underwent BEAM conditioning, 25 met the inclusion criteria with the main exclusion criterion being inadequate documentation. Eighteen had Hodgkin lymphoma, and seven had non-Hodgkin lymphoma. Median number of chemotherapy regimens pretransplant was 2 (1-3). Seventeen women (68%) with a median age at transplant of 25 yr (range 17-33) recovered their menses. The comparative group without recovery was older with a median age of 34 yr (range 20-40) (P = 0.007). Ten patients, with a median age at transplant of 22 yr (range 17-30), had 15 naturally conceived pregnancies. Chemotherapy regimens and lymphoma type did not obviously influence the incidence of menses recovery or conception. The incidence of recovery of menses and fertility in premenopausal women undergoing BEAM/ASCT for lymphoma is substantial. Younger age at transplant correlates with superior fertility outcomes.
authors.affiliation: Department of Clinical Haematology, Austin Hospital, Melbourne, Vic., Australia. masa.lasica@austin.org.au.
authors.forename: Masa
authors.initials: M
authors.lastname: Lasica
authors.affiliation: Department of Clinical Haematology, Princess Alexandra Hospital, Brisbane, QLD, Australia.
authors.forename: Emma
authors.initials: E
authors.lastname: Taylor
authors.affiliation: Department of Clinical Haematology, Westmead Hospital, Sydney, NSW, Australia.
authors.forename: Puja
authors.initials: P
authors.lastname: Bhattacharyya
authors.affiliation: Department of Clinical Haematology, Austin Hospital, Melbourne, Vic., Australia.
authors.forename: Ashwini
authors.initials: A
authors.lastname: Bennett
authors.affiliation: Department of Clinical Haematology, Royal Melbourne Hospital, Melbourne, Vic, Australia.
authors.forename: Rachel E
authors.initials: RE
authors.lastname: Cooke
authors.affiliation: Royal Women's Hospital, Melbourne, Vic., Australia.
authors.forename: Catharyn
authors.initials: C
authors.lastname: Stern
authors.affiliation: Royal Women's Hospital, Melbourne, Vic., Australia.
authors.forename: Franca
authors.initials: F
authors.lastname: Agresta
authors.affiliation: Royal Women's Hospital, Melbourne, Vic., Australia.
authors.forename: Rosemary
authors.initials: R
authors.lastname: Ayton
authors.affiliation: Department of Clinical Haematology, Austin Hospital, Melbourne, Vic., Australia.
authors.forename: Andrew
authors.initials: A
authors.lastname: Grigg
mesh_terms: D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D002330:Carmustine / Q000009:adverse effects / Q000627:therapeutic use; D003561:Cytarabine / Q000009:adverse effects / Q000627:therapeutic use; D005260:Female; D005298:Fertility / Q000187:drug effects; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008223:Lymphoma / Q000628:therapy; D008558:Melphalan / Q000009:adverse effects / Q000627:therapeutic use; D011034:Podophyllotoxin / Q000009:adverse effects / Q000627:therapeutic use; D017697:Premenopause; D012189:Retrospective Studies; D019172:Transplantation Conditioning / Q000009:adverse effects; D055815:Young Adult
chemical_list: D003561:Cytarabine; D011034:Podophyllotoxin; D008558:Melphalan; D002330:Carmustine
keywords: BEAM; autologous stem cell transplant; fertility; lymphoma; menopause