Gonadal status in reproductive age women after haematopoietic stem cell transplantation for haematological malignancies

Libuse Tauchmanova, Carmine Selleri, Gennaro De Rosa, Mariarosaria Esposito, Francesco Orio, Stefano Palomba, Giuseppe Bifulco, Carmine Nappi, Gaetano Lombardi, Bruno Rotoli, Annamaria Colao

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Ovarian failure is a frequent complication occurring after haematopoietic stem cell transplantion (SCT), which is generally ascribed to radiation treatment and antiblastic alkylating agents. Methods: Ovarian morphology and function were studied in reproductive age women 12-24 months after allogeneic SCT (n = 23) received from an HLA identical sibling, or autologous SCT (n = 22). Thirteen allo-transplanted women were suffering from chronic graft-versus-host disease (cGVHD). Results: Menstrual cycles recovered in two and four women in the allo- and auto-SCT groups respectively, being associated with younger age and longer period elapsed from transplant. There was no difference in previous use of alkylating agents between allo- and auto-transplantation, while corticosteroid treatment was longer and more recent in the allo-SCT group. Significantly higher gonadotrophin levels and lower estradiol were seen in the combined group of patients than in controls. In allo-transplanted women, androgens were also significantly lower than in controls. Ovarian and uterine volumes were lower in patients than in controls, and in the allo- than in the auto-transplanted women. Within the allo-SCT group, endocrine function and ovarian and uterine volumes were significantly lower in the patients suffering from cGVHD. Conclusion: Ovarian failure in SCT recipients is likely to be caused principally by myelo-ablative treatments, but the condition of gonadal and androgen insufficiency can be worsened by an altered immunomodulation in allogeneic setting.

Original languageEnglish
Pages (from-to)1410-1416
Number of pages7
JournalHuman Reproduction
Volume18
Issue number7
DOIs
Publication statusPublished - Jul 1 2003

Keywords

  • Busulphan
  • Cyclophosphamide
  • Graft-versus-host disease
  • Ovarian failure
  • Stem cell transplantation

ASJC Scopus subject areas

  • Physiology
  • Developmental Biology
  • Obstetrics and Gynaecology
  • Reproductive Medicine

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