The uterine volume is dramatically decreased after hematopoietic stem cell transplantation during childhood regardless of the conditioning regimen

Courbière, Blandine; Drikes, Benjamin; Grob, Anaïs; Hamidou, Zeinab; Saultier, Paul; Bertrand, Yves; Gandemer, Virginie; Plantaz, Dominique; Plat, Geneviève; Poirée, Maryline; Ducassou, Stéphane; Pochon, Cécile; Dalle, Jean‐Hugues; Thouvenin, Sandrine; Paillard, Catherine; Kanold, Justyna; Sîrvent, Anne; Rousset‐Jablonski, Christine; Duros, Solène; Gueniffey, Aurore; Cohade, Clémentine; Boukaïdi, S.; Frantz, Sandrine; Agopiantz, Mikaël; Poirot, Catherine; Genod, Anne; Pirrello, O.; Grémeau, Anne-Sophie; Bringer-Deutsch, S.; Auquier, Pascal; Gautier, Michel

doi:10.1016/j.fertnstert.2022.12.040

Cited by 7 publications

(5 citation statements)

References 22 publications

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“…The TBI-based conditioning in patients attending bone marrow transplant can affect both ovaries and uterus, with a reduced uterine development, probably due to radiation-induced fibrosis and vasculature damage (32). A very recent prospective cohort study, has shown that uterine volume is diminished in patients who have received bone marrow transplant rather independently from the conditioning regimen received, further confirming our results.…”

Section: Accepted Manuscriptsupporting

confidence: 89%

“…Further underlying the need of an individualized therapeutic approach, the present results also suggest that increasing TD 17β-oestradiol dose before progestin introduction, with the aim to optimize uterine outcome, could be completely useless in some specific patients with scarce uterine response to ERT and history of bone marrow transplant and pelvic irradiation (32). At this regard, increasing the dosage can be not only useless but also potentially harmful in CCS,…”

Section: Accepted Manuscriptmentioning

confidence: 73%

“…A very recent prospective cohort study, has shown that uterine volume is diminished in patients who have received bone marrow transplant rather independently from the conditioning regimen received, further confirming our results. The underlying mechanism is far from being elucidated, nonetheless there are some suggestions that alkylating agents could induce uterine damage as well (32). Consistently, after correction for CancerPOI, TD 17β-oestradiol dose at progesterone introduction was significantly associated to a better uterine response, thus suggesting that higher levels of TD 17β-oestradiol in the last part of the induction are required to optimize these…”

Section: Accepted Manuscriptmentioning

confidence: 92%

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Towards an individualized management of pubertal induction in girls with hypogonadism: insight into the best replacement outcomes from a large multicentre registry

et al. 2023

ESPE

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Objective: An evidence-based pubertal induction scheme in hypogonadal girls is still to be established. Interestingly, literature data reports suboptimal uterine longitudinal diameter (ULD) in >50% of treated hypogonadal women, negatively influencing their pregnancy outcomes. This study aims to investigate auxological and uterine outcomes of pubertal induction in girls in the light of underlying diagnosis and therapeutic schemes used.Design: Retrospective analysis of longitudinal data from a multicentric registry.Methods: Auxological, biochemical and radiological data were collected at baseline and during follow-up in 95 hypogonadal girls (chronological age>10.9 years, Tanner stage≤2) treated with transdermal 17β-oestradiol patches for at least one year. Induction was started at a median dose of 0.14 mcg/kg/day with a six-monthly increase and was considered completed for 49/95 patients who started progesterone with concomitant oestrogen adult dose. Significance statementSpecific evidence-based Consensus Guidelines for pubertal induction in girls with hypogonadism are still lacking. Moreover, more than 50% treated hypogonadal women show suboptimal uterine dimensions that can negatively influence their pregnancy outcomes. This represents the first longitudinal study on induction of puberty using transdermal 17β-oestradiol in a large cohort of hypogonadal females, counting more than a half patients cancer survivor. According to our results, progestins, hampering further changes in uterine and breast development, should be introduced only in the presence of an appropriate 17β-oestradiol dose and clinical response. If signs of endometrial hyperplasia occur in the presence of underdeveloped breasts or uterus, then a slight reduction in 17β-oestradiol should be taken into consideration to delay progesterone start.

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Section: Accepted Manuscriptsupporting

confidence: 89%

Section: Accepted Manuscriptmentioning

confidence: 73%

Section: Accepted Manuscriptmentioning

confidence: 92%

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Towards an individualized management of pubertal induction in girls with hypogonadism: insight into the best replacement outcomes from a large multicentre registry

et al. 2023

ESPE

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“…This study is an ancillary study of the FERTILEA study [19], approved by the Regional Ethics Committee (Comite ´de Protection des Personnes Sud Me ´diterrane ´e, 09/22/2017-N˚IDRCB: 2017-A01596-47, registered at ClinicalTrial.gov/NCT 03583294). Written consents were obtained from each participant when individual interviews were conducted.…”

Section: Ethical Approvalmentioning

confidence: 99%

Misconceptions and beliefs around hormone replacement therapy after childhood hematopoietic stem cell transplantation: A qualitative study among women leukemia survivors

et al. 2023

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Purpose After childhood leukemia and hematopoietic stem cell transplantation, hormone replacement therapy is often required to induce puberty because of premature ovarian insufficiency. Observance of this kind of treatment in adolescents and young women seems quite poor, and literature about its acceptance remains scarce; in order to learn about their experience and to better understand their attitude towards hormone replacement therapy, we used qualitative methods. Design and patients 13 young women childhood cancer survivors completed an individual interview. Results We report that the negative experience of leukemia may cause rejection of the treatment, closely related to infertility unacceptance. Misconceptions and lack of adequate information of hormonal treatment effects are also major barriers to a good compliance. Conclusions and implications for cancer survivors Observance of hormone replacement therapy for young women childhood cancer survivors can be improved with a confidential patient-physician relationship, patient education, choice of galenic formulation according to personal preference, and psychological support during the long-time follow up.

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“…As a consequence, there is a growing population of adult survivors that will face the long term side effects of cancer treatments such as growth failure, hypothyroidism, gonadal or uterine dysfunction or alteration of quality of life. 2,3 Indeed, Berbis and al in 2013 described that more than 70% of childhood leukemia survivors from the French cohort L.E.A. (Leucémie de l'Enfant et de l'Adolescent) were found to have at least one late side effect.…”

Section: Introductionmentioning

confidence: 99%

Ovarian Function and Spontaneous Pregnancy After Hematopoietic Stem Cell Transplantation for Leukemia Before Puberty: An L.E.A. Cohort Study

Chabut

Schneider

Courbière

et al. 2023

Transplantation and Cellular Therapy

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The uterine volume is dramatically decreased after hematopoietic stem cell transplantation during childhood regardless of the conditioning regimen

Cited by 7 publications

References 22 publications

Towards an individualized management of pubertal induction in girls with hypogonadism: insight into the best replacement outcomes from a large multicentre registry

Towards an individualized management of pubertal induction in girls with hypogonadism: insight into the best replacement outcomes from a large multicentre registry

Misconceptions and beliefs around hormone replacement therapy after childhood hematopoietic stem cell transplantation: A qualitative study among women leukemia survivors

Ovarian Function and Spontaneous Pregnancy After Hematopoietic Stem Cell Transplantation for Leukemia Before Puberty: An L.E.A. Cohort Study

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