期刊
JOURNAL OF OBSTETRICS AND GYNAECOLOGY
卷 36, 期 6, 页码 783-788出版社
TAYLOR & FRANCIS INC
DOI: 10.3109/01443615.2016.1154508
关键词
Haematopoietic stem cell transplantation; graft-versus-host disease; menstrual patterns; fertility; follicle-stimulating hormone; 17 beta-oestradiol
资金
- Associazione Italiana Ricerca contro il Cancro (A.I.R.C.) Milano, Fondi Finalizzati, Ministero Salute, Italia
- FARITMO Genova
- CARIGE Genova, Italy, Associazione Antonio Lanza, Genova
Two-hundred and sixty-nine females aged42 and undergoing an allogeneic stem cell transplant were retrospectively studied to assess the effect of age, conditioning regimen and chronic graft-versus-host disease (cGVHD) on resumption of stable menstrual cyclicity. Overall, a stable menstrual cyclicity was observed in 22% of cases. The cumulative probability of menses resumption was significantly age and conditioning regimen related. A statistically significant inverse correlation between cGVHD severity and menses resumption was observed only in univariate analysis. In patients with residual ovarian function, infertility was found in 43% and early menopause in 45%. An increased incidence of prematurity and low birth weight (LBW) was observed among the single spontaneous pregnancies. Follicle-stimulating hormone (FSH) and 17 beta-oestradiol levels were found to be inadequate to detect both early signs of menses resumption and menstrual stability. Our study confirms the crucial role of full dose total body irradiation (TBI) and age on menses recovery and fertility after haematopoietic stem cell transplantation (HSCT). The impact of severe cGVHD remains unclear.
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