Assessment of the ovarian reserve with anti-Müllerian hormone in women who underwent allogeneic hematopoietic stem cell transplantation using reduced-intensity conditioning regimens or myeloablative regimens with ovarian shielding

Hirofumi Nakano, Masahiro Ashizawa, Yu Akahoshi, Tomotaka Ugai, Hidenori Wada, Ryoko Yamasaki, Yuko Ishihara, Koji Kawamura, Kana Sakamoto, Miki Sato, Kiriko Terasako-Saito, Shun ichi Kimura, Misato Kikuchi, Hideki Nakasone, Shinichi Kako, Junya Kanda, Rie Yamazaki, Aki Tanihara, Junji Nishida, Yoshinobu Kanda

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Conditioning regimens that include cyclophosphamide (CY) and total body irradiation (TBI) induce severe gonadal toxicity and permanent infertility in approximately 90 % of female patients who undergo hematopoietic stem cell transplantation (HSCT). However, the use of ovarian shielding or non-myeloablative regimens may preserve ovarian function. To evaluate the ovarian reserve, serum anti-Müllerian hormone (AMH) levels were retrospectively measured in 11 female HSCT recipients aged less than 40 years, including seven with acute leukemia (AL) and four with aplastic anemia (AA), who received a myeloablative conditioning regimen with ovarian shielding or a reduced-intensity conditioning regimen. In most patients, menstruation had stopped and AMH level had decreased to an undetectable level (<0.1 ng/ml) after HSCT. Most patients showed a recovery of regular menstruation, but AMH levels did not increase immediately after the resumption of menstruation. However, in three AL patients and two AA patients who were evaluable for long-term recovery, AMH level increased gradually beyond 1 year after HSCT. In conclusion, recovery of the serum AMH level may be delayed after HSCT, and the AMH level early after HSCT may not accurately reflect ovarian reserve. A prospective study is required to address the usefulness of measuring the AMH level in HSCT recipients.

Original languageEnglish
Pages (from-to)110-116
Number of pages7
JournalInternational Journal of Hematology
Volume104
Issue number1
DOIs
Publication statusPublished - 2016 Jul 1
Externally publishedYes

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Hematopoietic Stem Cell Transplantation
Hormones
Menstruation
Aplastic Anemia
Leukemia
Whole-Body Irradiation
Ovarian Reserve
Serum
Cyclophosphamide
Infertility
Prospective Studies

Keywords

  • Anti-Müllerian hormone
  • Fertility
  • Hematopoietic stem cell transplantation
  • Ovarian reserve
  • Ovarian shielding

ASJC Scopus subject areas

  • Hematology

Cite this

Assessment of the ovarian reserve with anti-Müllerian hormone in women who underwent allogeneic hematopoietic stem cell transplantation using reduced-intensity conditioning regimens or myeloablative regimens with ovarian shielding. / Nakano, Hirofumi; Ashizawa, Masahiro; Akahoshi, Yu; Ugai, Tomotaka; Wada, Hidenori; Yamasaki, Ryoko; Ishihara, Yuko; Kawamura, Koji; Sakamoto, Kana; Sato, Miki; Terasako-Saito, Kiriko; Kimura, Shun ichi; Kikuchi, Misato; Nakasone, Hideki; Kako, Shinichi; Kanda, Junya; Yamazaki, Rie; Tanihara, Aki; Nishida, Junji; Kanda, Yoshinobu.

In: International Journal of Hematology, Vol. 104, No. 1, 01.07.2016, p. 110-116.

Research output: Contribution to journalArticle

Nakano, H, Ashizawa, M, Akahoshi, Y, Ugai, T, Wada, H, Yamasaki, R, Ishihara, Y, Kawamura, K, Sakamoto, K, Sato, M, Terasako-Saito, K, Kimura, SI, Kikuchi, M, Nakasone, H, Kako, S, Kanda, J, Yamazaki, R, Tanihara, A, Nishida, J & Kanda, Y 2016, 'Assessment of the ovarian reserve with anti-Müllerian hormone in women who underwent allogeneic hematopoietic stem cell transplantation using reduced-intensity conditioning regimens or myeloablative regimens with ovarian shielding', International Journal of Hematology, vol. 104, no. 1, pp. 110-116. https://doi.org/10.1007/s12185-016-1998-y
Nakano, Hirofumi ; Ashizawa, Masahiro ; Akahoshi, Yu ; Ugai, Tomotaka ; Wada, Hidenori ; Yamasaki, Ryoko ; Ishihara, Yuko ; Kawamura, Koji ; Sakamoto, Kana ; Sato, Miki ; Terasako-Saito, Kiriko ; Kimura, Shun ichi ; Kikuchi, Misato ; Nakasone, Hideki ; Kako, Shinichi ; Kanda, Junya ; Yamazaki, Rie ; Tanihara, Aki ; Nishida, Junji ; Kanda, Yoshinobu. / Assessment of the ovarian reserve with anti-Müllerian hormone in women who underwent allogeneic hematopoietic stem cell transplantation using reduced-intensity conditioning regimens or myeloablative regimens with ovarian shielding. In: International Journal of Hematology. 2016 ; Vol. 104, No. 1. pp. 110-116.
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abstract = "Conditioning regimens that include cyclophosphamide (CY) and total body irradiation (TBI) induce severe gonadal toxicity and permanent infertility in approximately 90 {\%} of female patients who undergo hematopoietic stem cell transplantation (HSCT). However, the use of ovarian shielding or non-myeloablative regimens may preserve ovarian function. To evaluate the ovarian reserve, serum anti-M{\"u}llerian hormone (AMH) levels were retrospectively measured in 11 female HSCT recipients aged less than 40 years, including seven with acute leukemia (AL) and four with aplastic anemia (AA), who received a myeloablative conditioning regimen with ovarian shielding or a reduced-intensity conditioning regimen. In most patients, menstruation had stopped and AMH level had decreased to an undetectable level (<0.1 ng/ml) after HSCT. Most patients showed a recovery of regular menstruation, but AMH levels did not increase immediately after the resumption of menstruation. However, in three AL patients and two AA patients who were evaluable for long-term recovery, AMH level increased gradually beyond 1 year after HSCT. In conclusion, recovery of the serum AMH level may be delayed after HSCT, and the AMH level early after HSCT may not accurately reflect ovarian reserve. A prospective study is required to address the usefulness of measuring the AMH level in HSCT recipients.",
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AU - Ashizawa, Masahiro

AU - Akahoshi, Yu

AU - Ugai, Tomotaka

AU - Wada, Hidenori

AU - Yamasaki, Ryoko

AU - Ishihara, Yuko

AU - Kawamura, Koji

AU - Sakamoto, Kana

AU - Sato, Miki

AU - Terasako-Saito, Kiriko

AU - Kimura, Shun ichi

AU - Kikuchi, Misato

AU - Nakasone, Hideki

AU - Kako, Shinichi

AU - Kanda, Junya

AU - Yamazaki, Rie

AU - Tanihara, Aki

AU - Nishida, Junji

AU - Kanda, Yoshinobu

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N2 - Conditioning regimens that include cyclophosphamide (CY) and total body irradiation (TBI) induce severe gonadal toxicity and permanent infertility in approximately 90 % of female patients who undergo hematopoietic stem cell transplantation (HSCT). However, the use of ovarian shielding or non-myeloablative regimens may preserve ovarian function. To evaluate the ovarian reserve, serum anti-Müllerian hormone (AMH) levels were retrospectively measured in 11 female HSCT recipients aged less than 40 years, including seven with acute leukemia (AL) and four with aplastic anemia (AA), who received a myeloablative conditioning regimen with ovarian shielding or a reduced-intensity conditioning regimen. In most patients, menstruation had stopped and AMH level had decreased to an undetectable level (<0.1 ng/ml) after HSCT. Most patients showed a recovery of regular menstruation, but AMH levels did not increase immediately after the resumption of menstruation. However, in three AL patients and two AA patients who were evaluable for long-term recovery, AMH level increased gradually beyond 1 year after HSCT. In conclusion, recovery of the serum AMH level may be delayed after HSCT, and the AMH level early after HSCT may not accurately reflect ovarian reserve. A prospective study is required to address the usefulness of measuring the AMH level in HSCT recipients.

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