The Role of LHRH-Analogues in
Protecting Gonadal Functions
during Chemotherapy and
Irradiation

Ed, Kreuser; Klingmüller, Dietrich; Thiel, Eckhard

doi:10.1159/000474586

Cited by 44 publications

(7 citation statements)

References 15 publications

(28 reference statements)

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“…(2) Obesity can also deteriorate testicular finction [ 1 1, 1341, and it is important to consider that obese people excrete organic solvents more slowly than nonobese persons, due to the amount of the compounds stored in the adipose tissue [22]. (3) Several drugs and pharmaceuticals can modify the hormonal levels [65]. Some products affect spermatogenesis [74], while others modify sexual potency and libido [42, 1241.…”

Section: Other Important Factorsmentioning

confidence: 99%

Toxicology of Male Reproduction in Animals and Humans

Célis

Pedrón-Nuevo

Feria‐Velasco

1996

Archives of Andrology

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Environmental contaminants can interfere with the male reproduction function. A review is presented of those pollutants with adverse effects on human reproduction. The possible effects of occupational and environmental exposure to various substances on male reproductive health are evaluated. This analysis considers studies showing damage of men exposed to halogenated hydrocarbons, other organic compounds, heavy metals and some physical agents, and some lifestyles, such as continuous stress, alcohol consumption, cigarette and marijuana smoking, and other addictions. Possible influences of these agents on the neuroendocrine system with the decrease of male fertility during the last decades are also discussed.

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Section: Other Important Factorsmentioning

confidence: 99%

Toxicology of Male Reproduction in Animals and Humans

Célis

Pedrón-Nuevo

Feria‐Velasco

1996

Archives of Andrology

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“…However, other researchers found no substantial protective effects in the mouse or in the rat to the same or other drugs 5–7 . Clinical trials have also failed to demonstrate any significant protective effect on spermatogenesis in patients treated with different kinds of anticancer drugs 8–11 …”

Section: Introductionmentioning

confidence: 99%

GnRH analog, leuprorelin acetate, promotes regeneration of rat spermatogenesis after severe chemical damage

et al. 2001

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Background: Future fertility is a major concern for cancer patients who undergo intensive chemotherapy. There has been controversy about whether hormonal treatments may have protective effects against the severe spermatogenic damage caused by chemotherapy or irradiation. Recently, it has been proposed that gonadotrophin-releasing hormone (GnRH) analogs administered after testicular damage stimulate the recovery of spermatogenesis. In this study, we have investigated the effects of GnRH agonist, leuprorelin, on the damage to spermatogenesis induced by busulfan. Methods: Fisher rats were treated with busulfan, 25 mg/kg, intraperitoneally. The effects of subcutaneous injections of leuprorelin before or after treatment were evaluated histologically 18 weeks later. Results:The percentage of 'recovered' seminiferous tubules was 27.7 ± 12.6% in control rats without leuprorelin and 26.9 ± 10.2% in rats with leuprorelin injected 4 weeks before busulfan. Rats in both groups showed poor recovery of spermatogenesis with an increase of intratesticular fluid. However, rats treated with leuprorelin three times (4 weeks apart) after busulfan showed an improvement of up to 56.5 ± 12.0% (P < 0.05). A focal but massive necrotic lesion in the testis was observed only in this group of rats. Conclusions:The results demonstrated that leuprorelin administered after chemical testicular damage enhanced the recovery of spermatogenesis. At the same time, a possible significant side-effect of leuprorelin was noted.

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“…14 Based on their action on the pituitary-gonadal axis, the use of LHRH analogues for gonadal protection has been suggested. Several investigators have suggested that inhibition of gametogenesis might reduce or even eliminate treatmentinduced gonadal injury 15 but there is no general consensus on this matter. In our study we failed to demonstrate any beneficial effect on gonadal function since early menopause was the norm in our patients.…”

Section: Discussionmentioning

confidence: 99%

Luteinizing hormone-releasing hormone analogue: leuprorelin acetate for the prevention of menstrual bleeding in premenopausal women undergoing stem cell transplantation

Chiusolo

Salutari

Sica

et al. 1998

Bone Marrow Transplant

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Summary:Prevention of uterine bleeding after stem cell transplantation was attempted in 30 consecutive premenopausal women affected by hematological malignancies. This was with luteinizing hormone-releasing hormone (LHRH) leuprorelin acetate depot 3.75 mg administered subcutaneously at least 30 days before the conditioning regimen and then 28 days after the first dose. Complete prevention resulted in all but one patient (96.5%) during the phase of profound thrombocytopenia. No sideeffects related to leuprorelin were observed. All patients developed amenorrhea after transplantation. Gonadal function was periodically assessed by means of luteinizing hormone (LH), follicular stimulating hormone (FSH) and estradiol serum levels. Hormone levels were consistent with menopause in all patients. After transplantation, patients required hormone replacement with estroprogestinics or estrogens alone when indicated. Leuprorelin is highly effective in preventing uterine bleeding in premenopausal women undergoing stem cell transplantation and has an excellent toxicity profile and virtually no interface with hemostatic balance and hepatic function. The role of leuprorelin in gonadal protection is currently unclear and deserves further investigations. Keywords: LHRH analogue; leuprorelin; menstrual bleeding; stem cell transplantation High-dose chemotherapy followed by stem cell transplantation is widely used for treating hematological malignancies and solid tumors. Supportive therapy is crucial for success and for reducing procedure-related toxicity. Uterine bleeding in premenopausal women undergoing myeloablative therapy can be an uncomfortable and troublesome complication. It also increases requirements for blood products and the attendant risks of immunization and infectious complications. Management may be difficult in patients with uterine leyomiomata and severe bleeding, excluding them from an effective anticancer treatment. The classical approach includes use of estroprogestinics which Correspondence: Dr P Salutari, Division of Hematology, Università Cattolica Sacro Cuore, Largo Agostino Gemelli, 8, 00168 Rome, Italy Received 13 August 1997; accepted 13 November 1997 need to be administered by mouth and can influence hemostasis 1 and hepatic function in patients already prone to systemic problems. 2 We investigated the role of leuprorelin, a LHRH analogue, in preventing uterine bleeding in premenopausal women undergoing high-dose chemotherapy and stem cell transplantation. The effect on gonadal function after transplantation was also assessed during follow-up. Patients and methodsPremenopausal women eligible for stem cell transplantation were entered into the trial with leuprorelin. Inclusion criteria were: presence of a hematological malignancy, age Ͻ50 years, anticipated nadir platelet count Ͻ50 × 10 9 /l, no episodes of amenorrhea lasting Ͼ6 months, hormone levels in the non-menopausal range. Informed consent was obtained from all patients or guardians after discussion with the consultant gynecologist. Gonadal function...

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The Role of LHRH-Analogues in Protecting Gonadal Functions during Chemotherapy and Irradiation

Cited by 44 publications

References 15 publications

Toxicology of Male Reproduction in Animals and Humans

Toxicology of Male Reproduction in Animals and Humans

GnRH analog, leuprorelin acetate, promotes regeneration of rat spermatogenesis after severe chemical damage

Luteinizing hormone-releasing hormone analogue: leuprorelin acetate for the prevention of menstrual bleeding in premenopausal women undergoing stem cell transplantation

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