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- Title
Gonadal function and fertility after stem cell transplantation in childhood: comparison of a reduced intensity conditioning regimen containing melphalan with a myeloablative regimen containing busulfan.
- Authors
Panasiuk, Anna; Nussey, Stephen; Veys, Paul; Amrolia, Persis; Rao, Kanchan; Krawczuk‐Rybak, Maryna; Leiper, Alison
- Abstract
The occurrence of late sequelae after myeloablative conditioning regimens for stem-cell transplantation ( SCT) has prompted the introduction of reduced-intensity chemotherapy ( RIC) regimens in an attempt to reduce toxicity and spare fertility. We retrospectively evaluated gonadal function in survivors of SCT in childhood by comparing patients conditioned with a myeloablative regimen containing busulfan and cyclophosphamide (BuCy, N = 51, 28 boys) and a RIC regimen containing fludarabine and melphalan (FluMel, N = 40, 19 boys). Spontaneous puberty occurred in 56% of girls and 89% of boys after BuCy, whereas 90% of females and all males in the FluMel group entered puberty spontaneously ( P = 0·012). Significantly more females (61%) conditioned with BuCy required hormone replacement compared with the FluMel group (10·5%, P = 0·012). Females in the FluMel group took significantly longer to develop elevation of serum follicle-stimulating hormone ( FSH) concentrations (>10 iu/l) from the onset of puberty than females in the BuCy group (median 5·2 years vs. 2·7 years respectively, P = 0·0135). In males no difference was noted between the two conditioning groups in time to FSH elevation (median 4 years in FluMel versus 6 years in BuCy). Whilst the two regimens have similar effects on the testis, ovarian function seems to be better preserved in females undergoing SCT with RIC.
- Subjects
STEM cell transplantation; MELPHALAN; CANCER chemotherapy; BUSULFAN; COMPARATIVE studies; JUVENILE diseases; THERAPEUTICS
- Publication
British Journal of Haematology, 2015, Vol 170, Issue 5, p719
- ISSN
0007-1048
- Publication type
Article
- DOI
10.1111/bjh.13497