Prevention of ovarian function damage by a GnRH analogue during chemotherapy in Hodgkin lymphoma patients

Abstract

Study showed a significant reduction of ovarian failure risk in women with HL treated with less aggressive CHT regimens plus a GnRH analogue.

Fertility status of Hodgkin lymphoma patients treated with chemotherapy and adjuvant gonadotropin-releasing hormone analogues

“…These patients are in the greatest risk of chDOR and also other means of fertility preservation as oocyte/embryo or ovarian tissue cryopreservation should be offered to them prior initiation of chemotherapy, if possible. Our observations are consistent with previous studies that also indicated limited or no protection of the ovarian follicle pool with GnRH-a in young women treated with EB chemotherapy -regimen C in our study [13,17].…”

“…Previously published studies report a high percentage of women with chDOR after treatment of HL, if no GnRH-a protection is received. In our previous studies, we recorded 71.0 % cases of chDOR 1 year after the end of chemotherapy [13]. Dann et al confirmed a 40.0 % chDOR rate in 4 years follow-up time [21].…”

“…The reproductive status of women with FSH levels over 15 IU/l was considered as chemotherapy induced diminished ovarian reserve (chDOR). The cut-off value was established based on European Society of Human Reproduction and Embryology (ESHRE) definition of ovarian factor of infertility [11], laboratory definition of diminished ovarian reserve [12], and our experience [13]. The second outcome parameter observed was achievement of clinical pregnancy during the study follow-up period.…”

Pharmacological options for the protection of ovarian function in patients undergoing chemotherapy

“…There were unexpectedly high incidences of POF in the control group in two larger studies by Castelo-Branco et al and Huser et al 46,47 The expected rate of POF in the population not treated with GnRH agonists is usually in the region of 32-37%, as found in other studies on Hodgkin's lymphoma survivors. 50,51 The high POF rate in the control group in the two larger studies influences any meta-analysis currently performed.…”

Antagonists of growth hormone releasing hormone (GHRH) given before whole body radiation lead to modulation of radiation response and organ-specific changes in the expression of angiogenesis

“…However, until confirmatory studies are completed, the cutoff of 10 Gy will be referenced in our discussion of radiation sensitization. It has already been demonstrated that induction of gonadal inhibition by treatment with LHRH agonists or antagonists can reduce the deleterious effects of chemotherapy and radiation on testicular and ovarian function [19][20][21][22]. With the exception of the 8.5 Gy findings discussed above, results from present and previous studies showed a radioprotective effect, with longer survivals, when GHRH antagonists were given before doses of less than 10 Gy of whole body radiation (XRT) in C3H mice.…”