6533b853fe1ef96bd12ac362
RESEARCH PRODUCT
Gonadotropin-releasing hormone agonist for the prevention of chemotherapy-induced ovarian failure in patients with lymphoma: 1-year follow-up of a prospective randomized trial.
Rene-olivier CasasnovasPauline BriceDominique BronIsabelle DemeesterePierre ZacheeJulie DecheneYvon EnglertAlain KentosIsabelle GaillardVivianne De MaertelaerFedro A. PeccatoriEric Van Den Nestesubject
Cancer ResearchTime FactorsLymphomamedicine.medical_treatmentGonadotropin-Releasing Hormone -- agonistsPrimary Ovarian InsufficiencyTriptorelin Pamoate -- therapeutic uselaw.inventionGonadotropin-Releasing HormoneGynécologieRandomized controlled triallawAntineoplastic Combined Chemotherapy ProtocolsClinical endpointBiological Markers -- bloodNorethindrone -- therapeutic useProspective StudiesTreatment FailureProspective cohort studyTriptorelin PamoateEstradiolLymphoma Non-HodgkinLymphoma -- drug therapyMiddle AgedTriptorelinHodgkin DiseasePremature ovarian failureLuteolytic AgentsOncologyHodgkin Disease -- drug therapyDrug Therapy CombinationFemaleEstradiol -- bloodmedicine.drugAdultAntineoplastic Combined Chemotherapy Protocols -- administration & dosage -- adverse effectsmedicine.medical_specialtyNorethisteronemedicine.drug_classUrologyFollicle Stimulating Hormone -- bloodGonadotropin-releasing hormone agonistmedicineHumansGynecologyChemotherapybusiness.industrymedicine.diseaseLuteolytic Agents -- therapeutic useCancérologieLymphoma Non-Hodgkin -- drug therapyPremenopausePrimary Ovarian Insufficiency -- blood -- chemically induced -- prevention & controlFollicle Stimulating HormoneNorethindronebusinessBiomarkersFollow-Up Studiesdescription
PURPOSE To assess the efficacy of gonadotropin-releasing hormone agonist (GnRHa) in preventing chemotherapy-induced ovarian failure in patients treated for Hodgkin or non-Hodgkin lymphoma within the setting of a multicenter, randomized, prospective trial. PATIENTS AND METHODS Patients age 18 to 45 years were randomly assigned to receive either the GnRHa triptorelin plus norethisterone (GnRHa group) or norethisterone alone (control group) concomitantly with alkylating agents containing chemotherapy. The primary end point was the premature ovarian failure (POF) rate (follicle-stimulating hormone [FSH] ≥ 40 IU/L) after 1 year of follow-up. Results Eighty-four of 129 randomly assigned patients completed the 1-year follow-up. The mean FSH values were higher in the control group than in the GnRHa group during chemotherapy; however, this difference was no longer observed after 6 months of follow-up. After 1 year, 20% and 19% of patients in the GnRHa and control groups, respectively, exhibited POF (P = 1.00). More than half of patients in each group completely restored their ovarian function (FSH < 10 IU/L), but the anti-Müllerian hormone values were higher in the GnRHa group than in the control group (1.4 ± 0.35 v 0.5 ± 0.15 ng/mL, respectively; P = .040). The occurrence of adverse events was similar in both groups with the exception of metrorrhagia, which was more frequently observed in the control group than the GnRHa group (38.4% v 15.6%, respectively; P = .024). CONCLUSION Approximately 20% of patients in both groups exhibited POF after 1 year of follow-up. Triptorelin was not associated with a significant decreased risk of POF in young patients treated for lymphoma but may provide protection of the ovarian reserve.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2013-03-01 |