Table 1.
Author, location | Patient population | Study type | GnRHa, dose, timing | Chemotherapy | Definition of premature ovarian failure | Duration of patient follow-up |
---|---|---|---|---|---|---|
Blumenfeld et al. 20056 Israel | Lymphoma (Hodgkin and non-Hodgkin) Age 14–40 | Prospective Controls: referred after therapy started or did not want GnRHa |
Triptorelin 3.75 mg i.m. q4wks | Various XRT in 65% |
Amenorrhea, estradiol <100 pmol/L, and FSH > 25 IU/L | Not reported |
Blumenfeld et al. 200010 Israel | SLE (7) Nephrotic syndrome (1) |
Prospective. Nonrandomized |
Triptorelin 3.75 mg i.m. q4wks | CYCa or chlorambucil with CYC dose GnRHa: 6–11 g No GnRHa: 4–26.5 g |
Amenorrhea, estradiol <100 pmol/L, and FSH > 25 IU/L | GnRHa: 2–15 years (average 8.3 years) No GnRHa: 4–15 years (average 9 years) |
Castelo-Branco et al. 200711 Spain | Hodgkin's Age 14–45 |
Prospective, Nonrandomized. | Triptorelin 3.75 mg i.m. q4wks (1st dose 1–2 wks before chemotherapy) And Tibolone qd to decrease low estrogen effects |
Various: ABVD: 10 of each group ABVD + XRT: 10 GnRH, 7 control |
No regular Menses | Not reported, but all patients enrolled “during the same period” of time |
Dann et al. 200512 Israel | Non-Hodgkin's lymphoma Age 18–40 (median 27) |
Prospective. Offered GnRHa to women under 40. Nonrandomized |
Triptorelin 3.75 mg i.m. q4wks | Cumulative CYC dose: 8,000–12,000 mg/m2 10: CYC 3,000 mg/m2 over 2 days + doxorubicin 50 mg/m2, vincristine 1.4 mg/m2, prednisone 1: CYC 2500 mg/m2 2: CYC 2000 mg/m2 |
Cyclic ovarian function = regular menses + normal gonadotropin and sex steroid levels or follicles on U/S or pregnancy | Follow-up: 70 months (23–99) GnRHa: 23–95 months No GnRHa: 23–99 months |
Loverro, et al. 20077 Italy | Hodgkin's lymphoma Mean age 24.3 ± 6.6 | Prospective randomized | Triptorelin 3.25 mg i.m. qmonth Or Triptorelin 11.25 mg i.m. q3months |
13 patients: ABVD × 6 13 patients: ABVD × 5 alternating with C(M)OPP 3 patients: C(M)OPP alternative ABV, then DHAP 24 patients: Supradiaphragmatic radiation |
No menses within 12 months | GnRHa: 2.4 ± 1.7 years No GnRHa: 5.9 ± 4.5 years |
Pereyra Pacheco et al. 200113 Argentina | Adolescents with leukemia Group B: Postmenarche, treated with GnRHa Group C: Postmenarche, no GnRHa. |
Nonrandomized, nonblinded. Prospective for GnRHa patients, retrospective for controls. |
Leuprolide 3.75 mg IM q4wks Short-acting leuprolide given daily the 1st 2 weeks of treatment so chemotherapy could be started immediately |
Group B1: BMT6 Group B2: CVPP7 or ABVD, no BMT Group C: BMT |
Amenorrhea | Group B: 5 yrs. Group C: 6 yrs |
Petri et al. 200414 Johns Hopkins | Severe SLE Age < 40 |
Prospective cohort | Leuprolide 3.75 mg i.m. q4wks | Monthly CYC × 6, then q3months for 18 months Or High-dose CYC (50 mg/kg × d) |
FSH > 25 | Not reported |
Somers et al. 2005.15 University of Michigan | SLE Age 17–32 follow-up minimum 3 years |
Prospective for GnRHa patients, retrospective for controls | Leuprolide 3.75 mg i.m. q4wks (10 days prior to next CYC dose) 1st dose usually given after 1st CYC dose Depot provera q3m and estrogen patch |
CYC i.v. monthly × 6 months, then AZA or MMF Or CYC i.v. qm × 4 |
FSH > 40 and amenorrhea × 12 months Median time to POF: 4.3 years |
Minimum 3 years GnRHa: 3–9 years (median 5 years) No GnRHa: 4–17 years (median 10 years) |
Waxman et al. 19875 U.K. | Advanced Hodgkin's disease | Prospective, randomized | Buserelin 200 μg t.i.d. intranasal, starting 1 week before chemotherapy |
Up to 6 cycles of MVPP | Amenorrhea | Mean: GnRHa: 2.3 years No GnRHa: 2.0 years |
CYC, cyclophosphamide, ABVD; adriamycin, bleomycin, vinblastine, dacarbazine; C(M)OPP, cyclophosphamide, vincristine, procarbazine, prednisone; ABV, adriamycin, bleomycin, vinblastine; DHAP, dexamethasone, cytarabine, cisplatin; BMT, bone marrow transplant; CVPP, cyclophosphamide, vinblastine, procarbazine, prednisone; AZA, azathioprine; MMF, mycophenolate mofetil; MVPP, mustine, vinblastine, procarbazine, prednisolone; XRT, radiation; U/s, ultrasound.