Objectives: Triptorelin, a GnRH agonist analogue, may be administered to post-pubertalfemales with cancer who receive chemotherapy in order to obtain menstrual suppression and decrease the hemorrhage risk due to thrombocytopenia. Our objective is to evaluate iftriptorelin administration has also a protective role against gonadotoxicity of chemoterapeutic drugs.Methods: This retrospective observational analysis includes all females who received chemotherapy for cancer in our Unit from 2000 to 2013, aged between 10-17, who already had the menarche. After informed consent, they received monthly depot intramuscular triptorelinat the dose of 3.75 mg. This report includes patients who concluded their treatment since at least one year and who are still alive.We evaluated the long-term ovarian function looking forclinical signs and symptoms of ovarian damage as amenorrhea or menstrual changes.We also searched for possible pregnancies and abortions. We made a laboratory follow-up, dosingserum FSH, LH, PRL, E2 and progesterone, and an ovarian ultrasound.Results: Patients evaluable according to eligibility criteria are 29 (15 ymphomas, 11 leukemias, 1 PNET, 1 Ewing sarcoma, 1 rhabdomyosarcoma). Four of them received highdosechemotherapy (HDCT). Over the 25 patients who did not receive HDCT, only onedeveloped amenorrhea. The others maintained a normal ovarian function at clinical,laboratory and ultrasound evaluation. Three of them achieved spontaneous, physiologic pregnancy and gave birth to healthy babies. Three of the 4 patients who made HDCT developed premature ovarian failure (POF).Conclusions: During HDCT, it seems that triptorelin is not able to preserve the ovarianfunction. In this case it could be recommended triptorelin followed by cryopreservation ofovarian tissue or oocytes. Our study suggests that GnRH-a during chemotherapy may prevents POF in patients treated without HDCT, indicating both the appropriateness and the need of a prospective randomized trial with a larger population.

Triptorelin to preserve fertility in adolescents treated with chemotherapy for cancer. Pediatr Blood Cancer 61S2;305,2015 (, Toronto, Canada, 22-25 October, 2014.

CARUSO, Manuela Clementina Maria;RUSSO, Giovanna;DI CATALDO, Andrea
2014-01-01

Abstract

Objectives: Triptorelin, a GnRH agonist analogue, may be administered to post-pubertalfemales with cancer who receive chemotherapy in order to obtain menstrual suppression and decrease the hemorrhage risk due to thrombocytopenia. Our objective is to evaluate iftriptorelin administration has also a protective role against gonadotoxicity of chemoterapeutic drugs.Methods: This retrospective observational analysis includes all females who received chemotherapy for cancer in our Unit from 2000 to 2013, aged between 10-17, who already had the menarche. After informed consent, they received monthly depot intramuscular triptorelinat the dose of 3.75 mg. This report includes patients who concluded their treatment since at least one year and who are still alive.We evaluated the long-term ovarian function looking forclinical signs and symptoms of ovarian damage as amenorrhea or menstrual changes.We also searched for possible pregnancies and abortions. We made a laboratory follow-up, dosingserum FSH, LH, PRL, E2 and progesterone, and an ovarian ultrasound.Results: Patients evaluable according to eligibility criteria are 29 (15 ymphomas, 11 leukemias, 1 PNET, 1 Ewing sarcoma, 1 rhabdomyosarcoma). Four of them received highdosechemotherapy (HDCT). Over the 25 patients who did not receive HDCT, only onedeveloped amenorrhea. The others maintained a normal ovarian function at clinical,laboratory and ultrasound evaluation. Three of them achieved spontaneous, physiologic pregnancy and gave birth to healthy babies. Three of the 4 patients who made HDCT developed premature ovarian failure (POF).Conclusions: During HDCT, it seems that triptorelin is not able to preserve the ovarianfunction. In this case it could be recommended triptorelin followed by cryopreservation ofovarian tissue or oocytes. Our study suggests that GnRH-a during chemotherapy may prevents POF in patients treated without HDCT, indicating both the appropriateness and the need of a prospective randomized trial with a larger population.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/20.500.11769/112608
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