Decreased Transfusions in Premenopausal Patients Undergoing Allogeneic Hematopoietic Stem-Cell Transplantation Given Leuprolide According to an Abnormal Uterine Bleeding Algorithm.

Autor:	Nebgen DR; University of Texas MD Anderson Cancer Center, Department of Gynecologic Oncology and Reproductive Medicine, Houston, TX.; University of Texas MD Anderson Cancer Center, Clinical Effectiveness Subcommittee Houston, TX., Cheng L; University of Texas MD Anderson Cancer Center, Clinical Effectiveness Subcommittee Houston, TX.; University of Texas MD Anderson Cancer Center, Institute of Cancer Care Innovation, Houston, TX., Alousi AM; University of Texas MD Anderson Cancer Center, Department of Stem Cell Transplant and Cellular Therapy, Houston, TX., Ferrajoli A; University of Texas MD Anderson Cancer Center, Clinical Effectiveness Subcommittee Houston, TX.; University of Texas MD Anderson Cancer Center, Department of Leukemia, Houston, TX.
Jazyk:	angličtina
Zdroj:	JCO oncology practice [JCO Oncol Pract] 2024 Sep 16, pp. OP2400169. Date of Electronic Publication: 2024 Sep 16.
DOI:	10.1200/OP.24.00169
Abstrakt:	Purpose: Abnormal uterine bleeding (AUB) during allogeneic hematopoietic stem-cell transplantation (HSCT) leads to an increased need for transfusions. We developed an algorithm for the management of AUB that incorporated leuprolide and oral contraceptive pills (OCPs). Our aim was to evaluate whether treatment according to this algorithm reduced the number of transfusions. Methods: All premenopausal patients who underwent first HSCT from June 2016 to January 2022 were included in this retrospective cohort study. Patients were divided into three groups on the basis of whether they received no medications, treatment according to the algorithm (leuprolide 11.25 mg intramuscular every three months with or without OCPs), or continuous OCPs. The primary outcome was the total number of units of RBCs and platelets transfused. Results: Two hundred fourteen patients with a mean age of 36.6 years were studied. Diagnoses were AML/myelodysplastic syndrome (n = 136), ALL (n = 47), or other hematologic malignancies (n = 31). One hundred twenty-five patients (58.4%) experienced AUB. Patients who received leuprolide with or without OCP according to the algorithm had a significant reduction in the likelihood of RBC transfusions, odds ratio (OR), 0.91 (95% CI, 0.85 to 0.98), and platelet transfusions, OR, 0.84 (95% CI, 0.79 to 0.91), compared with patients who received no medications or continuous OCP. Conclusion: AUB is a common complication in premenopausal patients undergoing HSCT. Our algorithm of leuprolide with or without OCPs administered before HSCT led to reductions in the number of platelet and RBC transfusions.
Databáze:	MEDLINE
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