TY - JOUR
T1 - Anti-Müllerian hormone and Inhibin B after stem cell transplant in childhood
T2 - a comparison of myeloablative, reduced intensity and treosulfan-based chemotherapy regimens
AU - Leiper, Alison
AU - Houwing, Maite
AU - Davies, E. Graham
AU - Rao, Kanchan
AU - Burns, Siobhan
AU - Morris, Emma
AU - Laven, Joop
AU - van der Kooi, Anne Lotte
AU - van den Heuvel Eibrink, Marry
AU - Nussey, Stephen
N1 - Publisher Copyright:
© 2020, The Author(s), under exclusive licence to Springer Nature Limited.
PY - 2020/10/1
Y1 - 2020/10/1
N2 - Serum concentrations of Anti-Müllerian hormone (AMH) and Inhibin B were used to assess potential fertility in survivors of childhood haematopoietic stem cell transplantation (HSCT) after three chemotherapy-conditioning regimens of differing intensity. Of 428 patients transplanted between 1990–2012 for leukaemia and immunodeficiency 121 surviving '1 year after a single HSCT were recruited. Group A had a treosulfan-based regimen (low-toxicity); Group B had fludarabine/melphalan (Flu-Mel) (reduced-intensity) and Group C had busulphan/cyclophosphamide (Bu-Cy) (myelo-ablative). Mean age at HSCT and follow-up and length of follow-up were 3.6, 11.8 and 9.9 years. Mean AMH standard deviation scores (SDS) were significantly higher in Group A (−1.047) and Group B (−1.255) than Group C (−1.543), suggesting less ovarian reserve impairment after treosulfan and Flu-Mel than after Bu-Cy. Mean serum AMH concentration was significantly better with treosulfan ('1.0 μg/l) than with Flu-Mel or Bu-Cy. In males, mean Inhibin B SDS was significantly higher in Group A (−0.506) than in Group B (−2.53) and Group C (−1.23) with the Flu-Mel group suffering greatest impairment. In conclusion, a treosulfan-based regimen confers a more favourable outlook for gonadal reserve than Flu-Mel or Bu-Cy in both sexes. Higher values of Inhibin B after Bu-Cy than after Flu-Mel may reflect recovery over time.
AB - Serum concentrations of Anti-Müllerian hormone (AMH) and Inhibin B were used to assess potential fertility in survivors of childhood haematopoietic stem cell transplantation (HSCT) after three chemotherapy-conditioning regimens of differing intensity. Of 428 patients transplanted between 1990–2012 for leukaemia and immunodeficiency 121 surviving '1 year after a single HSCT were recruited. Group A had a treosulfan-based regimen (low-toxicity); Group B had fludarabine/melphalan (Flu-Mel) (reduced-intensity) and Group C had busulphan/cyclophosphamide (Bu-Cy) (myelo-ablative). Mean age at HSCT and follow-up and length of follow-up were 3.6, 11.8 and 9.9 years. Mean AMH standard deviation scores (SDS) were significantly higher in Group A (−1.047) and Group B (−1.255) than Group C (−1.543), suggesting less ovarian reserve impairment after treosulfan and Flu-Mel than after Bu-Cy. Mean serum AMH concentration was significantly better with treosulfan ('1.0 μg/l) than with Flu-Mel or Bu-Cy. In males, mean Inhibin B SDS was significantly higher in Group A (−0.506) than in Group B (−2.53) and Group C (−1.23) with the Flu-Mel group suffering greatest impairment. In conclusion, a treosulfan-based regimen confers a more favourable outlook for gonadal reserve than Flu-Mel or Bu-Cy in both sexes. Higher values of Inhibin B after Bu-Cy than after Flu-Mel may reflect recovery over time.
UR - http://www.scopus.com/inward/record.url?scp=85082978147&partnerID=8YFLogxK
U2 - 10.1038/s41409-020-0866-9
DO - 10.1038/s41409-020-0866-9
M3 - Article
C2 - 32231250
AN - SCOPUS:85082978147
SN - 0268-3369
VL - 55
SP - 1985
EP - 1995
JO - Bone Marrow Transplantation
JF - Bone Marrow Transplantation
IS - 10
ER -