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

Isabelle Demeestere, Pauline Brice, Fedro A. Peccatori, Alain Kentos, Isabelle Gaillard, Pierre Zachee, Rene Olivier Casasnovas, Eric Van Den Neste, Julie Dechene, Vivianne De Maertelaer, Dominique Bron, Yvon Englert

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Abstract

Purpose 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. Patients and 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-Mü llerian 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). Conclusion 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.

Original languageEnglish
Pages (from-to)903-909
Number of pages7
JournalJournal of Clinical Oncology
Volume31
Issue number7
DOIs
Publication statusPublished - Mar 1 2013

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Gonadotropin-Releasing Hormone
Lymphoma
Primary Ovarian Insufficiency
Drug Therapy
Follicle Stimulating Hormone
Control Groups
Triptorelin Pamoate
Norethindrone
Metrorrhagia
Ovarian Follicle
Alkylating Agents
Hodgkin Disease
Non-Hodgkin's Lymphoma
Hormones

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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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. / Demeestere, Isabelle; Brice, Pauline; Peccatori, Fedro A.; Kentos, Alain; Gaillard, Isabelle; Zachee, Pierre; Casasnovas, Rene Olivier; Neste, Eric Van Den; Dechene, Julie; Maertelaer, Vivianne De; Bron, Dominique; Englert, Yvon.

In: Journal of Clinical Oncology, Vol. 31, No. 7, 01.03.2013, p. 903-909.

Research output: Contribution to journalArticle

Demeestere, I, Brice, P, Peccatori, FA, Kentos, A, Gaillard, I, Zachee, P, Casasnovas, RO, Neste, EVD, Dechene, J, Maertelaer, VD, Bron, D & Englert, Y 2013, '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', Journal of Clinical Oncology, vol. 31, no. 7, pp. 903-909. https://doi.org/10.1200/JCO.2012.42.8185
Demeestere, Isabelle ; Brice, Pauline ; Peccatori, Fedro A. ; Kentos, Alain ; Gaillard, Isabelle ; Zachee, Pierre ; Casasnovas, Rene Olivier ; Neste, Eric Van Den ; Dechene, Julie ; Maertelaer, Vivianne De ; Bron, Dominique ; Englert, Yvon. / 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. In: Journal of Clinical Oncology. 2013 ; Vol. 31, No. 7. pp. 903-909.
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abstract = "Purpose 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. Patients and 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-M{\"u} llerian 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). Conclusion 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.",
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T1 - Gonadotropin-releasing hormone agonist for the prevention of chemotherapy-induced ovarian failure in patients with lymphoma

T2 - 1-year follow-up of a prospective randomized trial

AU - Demeestere, Isabelle

AU - Brice, Pauline

AU - Peccatori, Fedro A.

AU - Kentos, Alain

AU - Gaillard, Isabelle

AU - Zachee, Pierre

AU - Casasnovas, Rene Olivier

AU - Neste, Eric Van Den

AU - Dechene, Julie

AU - Maertelaer, Vivianne De

AU - Bron, Dominique

AU - Englert, Yvon

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N2 - Purpose 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. Patients and 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-Mü llerian 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). Conclusion 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.

AB - Purpose 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. Patients and 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-Mü llerian 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). Conclusion 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.

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