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Title: | Reproductive status in long-term bone marrow transplant survivors receiving busulfan-cyclophosphamide (120 mg/kg). | Authors: | Zajac J.;Szer J.;Grigg A.P.;McLachlan R. | Institution: | (Grigg, Szer) Bone Marrow Transplant Service, Department Clinical Haematology and Medical Oncology, Royal Melbourne Hospital, Parkville, Vic., Australia (McLachlan) Prince Henry's Institute of Medical Research, Monash Medical Centre, Clayton, Vic., Australia (Zajac) Department of Medicine, University of Melbourne, Parkville, Vic., Australia | Issue Date: | 20-Oct-2012 | Copyright year: | 2000 | Publisher: | Nature Publishing Group (Houndmills, Basingstoke, Hampshire RG21 6XS, United Kingdom) | Place of publication: | United Kingdom | Publication information: | Bone Marrow Transplantation. 26 (10) (pp 1089-1095), 2000. Date of Publication: 2000. | Abstract: | There are few published data on the recovery of fertility after 'little' Bu-Cy (busulfan 16 mg/kg, cyclophosphamide 120 mg/kg) conditioning for BMT. To address this, we identified 19 females aged less than 40 years at transplant and 47 males from a single centre who were alive a minimum of 2 years after BMT with little Bu-Cy as conditioning and who were evaluable for testing. FSH, LH, testosterone and inhibin B levels were measured in males. Twenty-six also had semen analysis, a median of 5 years post transplant; 21 had detectable sperm, with 11 having counts >20 x 106/ml. There was an association between prolonged chronic graft-versus-host disease and low sperm counts. FSH and inhibin B levels correlated with sperm counts but not to the extent that they could reliably predict counts in individual patients. An additional six of seven males attempting to father children did so, a median of 3.2 years post transplant. Low testosterone levels were noted in 12% of males, most of whom had symptoms consistent with androgen deficiency. FSH, LH and oestradiol levels in the absence of hormone replacement therapy were measured in females; all remained amenorrheic with endocrine evidence of ovarian failure. These results have implications for fertility counselling and hormone replacement therapy both pre-and post BMT. | DOI: | http://monash.idm.oclc.org/login?url=http://dx.doi.org/10.1038/sj.bmt.1702695 | PubMed URL: | 11108308 [http://www.ncbi.nlm.nih.gov/pubmed/?term=11108308] | ISSN: | 0268-3369 | URI: | https://repository.monashhealth.org/monashhealthjspui/handle/1/33370 | Type: | Article | Subjects: | female infertility/di [Diagnosis] immunosuppressive treatment major clinical study male male infertility/di [Diagnosis] male infertility/si [Side Effect] male infertility/th [Therapy] oligospermia/di [Diagnosis] oligospermia/si [Side Effect] ovary insufficiency/si [Side Effect] patient counseling priority journal *reproduction semen analysis spermatozoon count survival time androgen/ec [Endogenous Compound] *busulfan/ae [Adverse Drug Reaction] *busulfan/cb [Drug Combination] *busulfan/do [Drug Dose] *busulfan/dt [Drug Therapy] carmustine/ae [Adverse Drug Reaction] carmustine/cb [Drug Combination] carmustine/dt [Drug Therapy] chlorambucil *cyclophosphamide/ae [Adverse Drug Reaction] *cyclophosphamide/cb [Drug Combination] *cyclophosphamide/do [Drug Dose] *cyclophosphamide/dt [Drug Therapy] cytarabine/ae [Adverse Drug Reaction] cytarabine/cb [Drug Combination] cytarabine/dt [Drug Therapy] estradiol/ec [Endogenous Compound] etoposide/ae [Adverse Drug Reaction] etoposide/cb [Drug Combination] etoposide/do [Drug Dose] etoposide/dt [Drug Therapy] follitropin/ec [Endogenous Compound] inhibin B/ec [Endogenous Compound] luteinizing hormone/ec [Endogenous Compound] melphalan/ae [Adverse Drug Reaction] melphalan/cb [Drug Combination] melphalan/dt [Drug Therapy] testosterone/ec [Endogenous Compound] adolescent adult amenorrhea/si [Side Effect] article *bone marrow transplantation chronic disease controlled study convalescence dose response female female infertility/si [Side Effect] female infertility/th [Therapy] follow up graft versus host reaction/co [Complication] graft versus host reaction/dt [Drug Therapy] health status hormone blood level hormone deficiency/si [Side Effect] hormone substitution human immunosuppressive treatment human hormone substitution hormone deficiency / side effect male infertility / diagnosis / side effect / therapy oligospermia / diagnosis / side effect ovary insufficiency / side effect patient counseling priority journal *reproduction semen analysis spermatozoon count survival time graft versus host reaction / complication / drug therapy health status major clinical study male hormone blood level adolescent adult amenorrhea / side effect article *bone marrow transplantation chronic disease controlled study convalescence dose response female female infertility / diagnosis / side effect / therapy follow up |
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