The effects of hydroxyurea and bone marrow transplant on Anti-Müllerian hormone (AMH) levels in females with sickle cell anemia

Elchuri, Swati V.; Williamson, Rebecca; Brown, Robert C.; Haight, Ann E.; Spencer, Jessica B.; Buchanan, Iris; Hassen-Schilling, Leann; Brown, Milton R.; Mertens, Ann C.; Meacham, Lillian R.

doi:10.1016/j.bcmd.2015.03.012

Cited by 40 publications

(49 citation statements)

References 41 publications

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“…Of the nine HSCT patients assessed, all of them had undetectable anti-mullerian hormone and 89% has follicle-stimulating hormone levels in the menopausal range. [26] Similar results were found in the study by Dallas et al, in which only five of nine males and two of four females had normal gonadal function following transplantation. [15] Patients in this study had received MA conditioning, so further study must be done to assess the effect of NMA conditioning on fertility.…”

Section: Unique Challenges In Transplantation For Sickle Cell Diseasesupporting

confidence: 85%

Allogeneic stem cell transplantation for sickle cell disease

Robinson

Fuchs

2016

Current Opinion in Hematology

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Purpose of Review As the safety and availability of allogeneic hematopoietic stem cell transplantation (HSCT) have improved, this procedure is becoming a viable option for non-malignant conditions such as sickle cell disease (SCD). There are very few treatment options available for SCD, and even with optimal care SCD patients still suffer from a myriad of comorbidities to multiple organ systems and have a decreased life span. In this review we will summarize results from trials of HSCT for children or adults with SCD using a variety of graft sources as well as conditioning and GVHD prophylaxis regimens, and discuss the unique challenges that arise in these patients. Recent Findings AlloHSCT for SCD has been performed on small numbers of patients at multiple centers around the world using several different transplant platforms, and early outcomes are encouraging. Overall survival is excellent, although graft failure remains a challenge. Summary As alloHSCT becomes safer and more widely available, the procedure should be considered for patients with severe disease phenotypes in whom the potential benefits of transplantation outweigh the complications from the disease. AlloHSCT has been shown to reverse or at least halt the progression of end-organ damage secondary to SCD. More research is needed to understand the mechanisms underlying graft failure in SCD recipients, as well as to understand the biopsychosocial underpinnings of persistent pain in the post-transplant period to maximize the benefit from the transplant procedure.

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Section: Unique Challenges In Transplantation For Sickle Cell Diseasesupporting

confidence: 85%

Allogeneic stem cell transplantation for sickle cell disease

Robinson

Fuchs

2016

Current Opinion in Hematology

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“…An analysis conducted on 56 young girls with sickle cell anemia, aged between 10 and 19 years, showed that 24% of them had low AMH levels (<5th centile). This group of subjects with low AMH levels was treated for a longer period compared with the group with normal AMH levels (6.8 ± 1.9 years vs 4.0 ± 2.5 years of treatment; P = 0.007) . However, no data are available in older women (>21 years old) and the long‐term effects of hydroxyurea on ovarian function should be further investigated .…”

Section: Benign Hematological Diseasesmentioning

confidence: 99%

“…This group of subjects with low AMH levels was treated for a longer period compared with the group with normal AMH levels (6.8 ± 1.9 years vs 4.0 ± 2.5 years of treatment; P = 0.007). 17…”

Section: B Eni G N Hematolog I C Al D Is E a S E Smentioning

confidence: 99%

Challenges of fertility preservation in non‐oncological diseases

Condorelli

Demeestere

2019

Acta Obstet Gynecol Scand

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Clinicians should provide fertility counseling to all patients receiving gonadotoxic treatment. International scientific societies have mainly focused on oncological patients, and fewer efforts have been made to apply these recommendations to women diagnosed with benign disease (eg benign hematological diseases, autoimmune diseases, and gynecological or genetic disorders). However, these indications account for 8%‐13% of the demand for fertility preservation. The risk of premature ovarian failure due to treatment, or to the disease itself, can be considered fairly high for many young women. Counseling and adequate management of these women require particular attention due to the severe health conditions that are associated with some of these diseases. In this review, we address specific issues related to providing adequate fertility counseling and management for women who have been diagnosed with the major non‐oncological indications, based on the literature and on our clinical experience.

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“…AMH is solely produced in the growing ovarian follicles and does not show clinically relevant changes across the menstrual cycle [19]. Investigation of the effects of treatment regimens used in SCD on gonadal function show that AMH levels were low in peripubertal patients with SCD who had undergone bone marrow transplantation and in patients who had been treated with gonadotoxic agents such as hydroxycarbamide [20]. This is not surprising, as common preparation for bone marrow transplant involves exposure to gonadotoxic alkylating agents such as cyclophosphamide and busulfan.…”

Section: Introductionmentioning

confidence: 99%

Ovarian reserve in women with sickle cell disease

et al. 2019

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Background It has been proposed that ovarian sickling and/or iron overload in women with sickle cell disease (SCD) could contribute to gonadal dysfunction, but there are very few published studies. We hypothesised that the above phenomena might impair ovarian reserve. Methods A total of 50 SCD patients were case-matched by age, ethnicity, and presence of regular cycles (28±5 days) with 73 patients without a known haemoglobinopathy who required anti-Müllerian hormone (AMH) assessment in a gynaecology clinic. SCD patients had AMH levels taken as part of routine care. The patients were case-controlled and matched with patients who had no haemoglobinopathy in a tertiary centre over a period of one year. Results The mean AMH in the SCD case group was 7.6 pmol/l compared with 13.4 pmol/l in the control group (p<0.001). The AMH distributions were subsequently categorised. This showed that SCD patients had a significantly higher chance of having lower AMH in comparison with the control group (OR 2.6 (CI 1.1–6.5, P = 0.02). The proportion of women with AMH > 20 pmol/l was significantly lower in the SCD group (6%) in comparison with the control group (19%) (P = 0.04). Conclusions This is the first study showing that women of reproductive age with SCD are more likely to have a low ovarian reserve at a younger age in comparison with patients with no haemoglobinopathy.

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The effects of hydroxyurea and bone marrow transplant on Anti-Müllerian hormone (AMH) levels in females with sickle cell anemia

Cited by 40 publications

References 41 publications

Allogeneic stem cell transplantation for sickle cell disease

Allogeneic stem cell transplantation for sickle cell disease

Challenges of fertility preservation in non‐oncological diseases

Ovarian reserve in women with sickle cell disease

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