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Ovarian AMH production is transiently affected in pubertal and prepubertal girls with acute lymphoblastic leukaemia and non-Hodgkin lymphoma receiving chemotherapy: a prospective, longitudinal study - Ovarian AMH production is transiently affected in pubertal and prepubertal girls with acute lymphoblastic leukaemia and non-Hodgkin lymphoma receiving chemotherapy: a prospective, longitudinal study
Congreso
Authorship:
LOPEZ DACAL, JIMENA CLAUDIA ; Silvina Prada ; Marcela E. Gutierrez ; Patricia Bedecarrás ; María Gabriela Ropelato ; Andrea Arcari ; Maria Gabriela Ballerini ; Mirta Gryngarten ; Marcela Soria ; Lorena Morán ; Cristina E. Ferraro ; Analia freire ; Ignacio Bergadá ; Guillermo Drelichman ; Luis Aversa ; Rodolfo A. Rey ; Grinspon, Romina P.Date:
2021Publishing House and Editing Place:
KargerSummary *
Introduction: Improvements in the treatment of acute lym- phoblastic leukaemia (ALL) and non-Hodgkin lymphoma (NHL) have increased survival, with the consequent concern about the long-term effects that childhood chemotherapy may have on ovar- ian function. AMH constitutes an indirect, reliable biomarker of the ovarian reserve, useful for the assessment of cancer therapy- related ovarian damage.Aim: To evaluate small ovarian follicle status in girls and ado- lescents with hematologic malignancies during and after treatment (Post Tx). Methods: prospective cohort study in children with ALL or NHL. Serum AMH was measured (EIA Inmunotech-Beckmann- Coulter) at diagnosis, during chemotherapy and until 3 year after treatment completion. Secondarily, FSH levels were analysed. Results were interpreted according to age or pubertal stage as appropriate and expressed as median (range). Results: Twenty-three girls aged 7,3 yr (1-15,7) were included; 15 were prepubertal and 8 were pubertal at diagnosis. NHL was diagnosed in 4 (17,4%) and ALL in 19 (82,6%), of which 6/19 (31,6%) were high risk and 13 (68,4%), intermediate or standard risk. Total follow-up was 4,7 yr (3-5,1).AMH was low (<3 centile) in 20 patients (86.9%) at some point during treatment. In 4 girls AMH was low since diagnosis. In the others, a marked decrease in AMH was observed between 6 and 12 months of treatment.Fifteen out of 20 (75%) patients recovered normal serum AMH. (Table); 4 of the 5 girls who did not recover AMH had basal AMH<25 centile and a diagnosis of high-risk ALL or NHL, receiving more aggressive chemotherapy. A mild and transient increased FSH was seen in 12 (52,1%), 7 prepubertal and 5 pubertal.All girls who received pubertal inhibition treatment recovered their sexual cycles within 7 months of suspension.Conclusion: These preliminary results suggest that most girls with ALL or NHL suffered a transient impairment of the small ovarian follicle pool during chemotherapy, with recovery in a large majority of them in the long-term. Most of the girls with persis- tently low AMH had received more aggressive chemotherapy. Information provided by the agent in SIGEVAKey Words
ovarian functionhaematological mailgnanciesgirls and adolescentsAMH