Anti-Müllerian Hormone in Female Adolescent Cancer Patients Before, During, and After Completion of Therapy: A Pilot Feasibility Study
| Autor: | Anne Marie Maloney, Samantha Knight, Lisa Allen, Abha A. Gupta, Catherine Deveault, Jeffrey Traubici, Armando J. Lorenzo, Amy Lee Chong |
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| Rok vydání: | 2015 |
| Předmět: |
Adult
Anti-Mullerian Hormone endocrine system Pediatrics medicine.medical_specialty Cyclophosphamide Adolescent Population Pilot Projects Primary Ovarian Insufficiency Premature ovarian insufficiency 03 medical and health sciences 0302 clinical medicine Neoplasms medicine Humans Fertility preservation Prospective Studies Survivors education Child Amenorrhea Antineoplastic Agents Alkylating Gynecology education.field_of_study 030219 obstetrics & reproductive medicine biology business.industry Cumulative dose Obstetrics and Gynecology Cancer Anti-Müllerian hormone General Medicine medicine.disease 030220 oncology & carcinogenesis Pediatrics Perinatology and Child Health biology.protein Feasibility Studies Female medicine.symptom business medicine.drug |
| Zdroj: | Journal of pediatric and adolescent gynecology. 29(6) |
| ISSN: | 1873-4332 |
| Popis: | Study Objective Alkylating agents are implicated in premature ovarian insufficiency. To optimize counseling regarding future ovarian function in survivors of adolescent cancer, we describe anti-Mullerian hormone (AMH) levels in female adolescents at diagnosis, during, and shortly after completion of chemotherapy. Design, Setting, Participants, Interventions, and Main Outcome Measures This was a prospective single-institution study. Participants were a mixed population of newly diagnosed postmenarchal female adolescents with malignancy. AMH was performed at diagnosis (T1), 6 months from diagnosis (T2), at end of therapy or 12 months [T3, whichever came first], 1 year after the end of therapy or 24 months from diagnosis [T4, whichever came first], and 18 months from the time of diagnosis (T5). All patients had baseline pelvic ultrasound examinations. Presence of menses and hot flashes were recorded at each time point. Results Sixteen participants with a median age at diagnosis of 14.3 years (range 12-17 years) were followed for 18.2 months (range, 14-24 months). Oncology diagnoses included leukemia, lymphoma, and sarcoma. Ten patients (62.5%) received alkylating agents with a median cumulative dose of 3041 mg/m 2 (range, 2639-6478 mg/m 2 ) of cyclophosphamide. Almost half (n = 7; 44%) experienced amenorrhea during treatment with resumption of menses in 6 of 7 patients (85%). Fifteen of 16 (94%) participants showed a decline in mean AMH levels by 6 months (T2) from diagnosis (15.8 IU/mL at T1 vs 6.5 IU/mL at T2; P = .003) and 12 of 15 (80%) showed at least some recovery of AMH (mean AMH at T4 = 13.2 IU/mL compared with 6.5 IU/mL at T2; P = .02). There was no difference in the mean decline nor recovery of AMH in those who did, vs did not receive cyclophosphamide. Conclusion To our knowledge, this is the largest series to date in adolescents showing that AMH is uniformly suppressed during cancer therapy and short-term recovery occurs in just more than half of the patients by 18-24 months. The contribution of short-term AMH measurements in predicting long-term ovarian function remains to be defined. Long-term follow-up with serial AMH levels is required to help predict those at risk for premature ovarian insufficiency. |
| Databáze: | OpenAIRE |
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