Ovarian reserve and premature ovarian failure in girls and adolescents after hematopoietic stem cell transplantation

Paris, Claudia; Zepeda, Ana; Muñoz, Mónica; Camus, Adela; Catalán, Paula; Sotomayor, Cristian; Luengo, Rosario; Schulin-Zeuthem, Carolina; Brieba, Mariela; Romero Fuentes, Patricia

Reserva ovárica y falla ovárica prematura en niñas y adolescentes postrasplante de progenitores hematopoyéticos

dc.contributor		en-US
dc.contributor	Proyecto Interno Investigación, Universidad de Chile, Hospital Luis Calvo Mackenna	es-ES
dc.creator	Paris, Claudia
dc.creator	Zepeda, Ana
dc.creator	Muñoz, Mónica
dc.creator	Camus, Adela
dc.creator	Catalán, Paula
dc.creator	Sotomayor, Cristian
dc.creator	Luengo, Rosario
dc.creator	Schulin-Zeuthem, Carolina
dc.creator	Brieba, Mariela
dc.creator	Romero Fuentes, Patricia
dc.date	2022-02-14
dc.date.accessioned	2022-05-09T15:02:43Z
dc.date.available	2022-05-09T15:02:43Z
dc.identifier	http://www.revistachilenadepediatria.cl/index.php/rchped/article/view/3693
dc.identifier	10.32641/andespediatr.v93i1.3693
dc.identifier.uri	https://revistaschilenas.uchile.cl/handle/2250/182265
dc.description	The increased survival of children and adolescents after Stem Cell Transplantation (SCT) has allowed us to gain a better understanding of the late effects that this procedure might have. Objective: to measure ovarian function and reserve after SCT. Patients and Method: A descriptive, observatio- nal, and cross-sectional study of girls and adolescents with SCT between 1999 and 2011. External gynecologic examination, hormone tests, and abdominal gynecologic ultrasound were performed, observing pubertal development pre-SCT. The following data from the clinical record were recorded: baseline pathology, type of conditioning, use of radiotherapy in conditioning, age at the time of SCT, and history of acute or chronic graft-versus-host disease (GVHD). Hormonal tests included follicle- stimulating hormone (FSH), luteinizing hormone (LH), estradiol, prolactin (PRL), thyroid-stimula- ting hormone (TSH), free thyroxine, total testosterone, sex hormone-binding globulin (SHBG), and anti-Müllerian hormone (AMH). Statistical analysis included the chi-square or Fisher’s Exact test with a p-value < 0.05. Results: 41 patients were evaluated. The median age at the time of SCT was 6.8 years (1.5-14.1) and the median age at evaluation was 14.8 years (range: 4-25.4 years). 93% of the transplants were in patients with oncological disease and with myeloablative conditioning regimens. All patients presented decreased ovarian reserve, and 72% showed Premature Ovarian Failure (POF). Conclusions: All patients had decreased ovarian reserve and most of them had a high prevalence of POF. Before SCT, a gynecological evaluation and subsequent follow-up for hormone monitoring and initiation of hormone replacement are essential.	en-US
dc.description	El aumento de la sobrevida de niñas y adolescentes después de un trasplante de progenitores hemato- poyéticos (TPH) ha permitido conocer los efectos tardíos de esta terapia. Objetivo: medir la reserva y la falla ováricas prematura después de un TPH.Pacientes y Método: estudio descriptivo, transversal de niñas y adolescentes trasplantadas entre 1999-2011. Se realizó examen ginecológico, exámenes hormonales y ecotomografía ginecológica transabdominal, y se consignó desarrollo puberal pre TPH. Se registraron los siguientes datos de la ficha clínica: patología de base, tipo de acondicionamiento, uso de radioterapia en el acondicionamiento, edad al momento del TPH y haber tenido o tener enfermedad del injerto contra el huésped (EICH) aguda o crónica. Los exámenes hormonales incluyeron hormona folículo estimulante (FSH), hormona luteinizante (LH), estradiol, prolactina (PRL), hormona tiroestimulante (TSH), tiroxina libre, testosterona total, proteína transportadora de hormonas sexuales (SHBG) y hormona antimulleriana (AMH). Análisis estadístico: chi cuadrado y exacto de Fisher con P < 0,05. Resultados fueron expresados como mediana (rango). Resultados: Se evaluaron 41 pacientes, edad al momento del TPH de 6,8 años (1,5-14,1) y 14,8 años (rango: 4-25,4) al momen- to de la evaluación. El 93% de las pacientes trasplantadas tenían patologías oncológicas y recibieron regímenes de acondicionamiento mieloablativos. Todas mostraron una reserva ovárica disminuida. El 72% de las pacientes presentaron una falla ovárica prematura (FOP). Conclusiones: Todas las pacientes estudiadas tenían una reserva ovárica disminuida y la mayoría de ellas una alta prevalencia de FOP. Es indispensable una evaluación ginecológica antes del TPH y un seguimiento posterior para monitorización hormonal e inicio del reemplazo hormonal.	es-ES
dc.format	application/pdf
dc.format	application/pdf
dc.language	spa
dc.language	eng
dc.publisher	Sociedad Chilena de Pediatría	es-ES
dc.relation	http://www.revistachilenadepediatria.cl/index.php/rchped/article/view/3693/3742
dc.relation	http://www.revistachilenadepediatria.cl/index.php/rchped/article/view/3693/3931
dc.relation	http://www.revistachilenadepediatria.cl/index.php/rchped/article/downloadSuppFile/3693/10899
dc.relation	http://www.revistachilenadepediatria.cl/index.php/rchped/article/downloadSuppFile/3693/10904
dc.relation	http://www.revistachilenadepediatria.cl/index.php/rchped/article/downloadSuppFile/3693/10905
dc.relation	http://www.revistachilenadepediatria.cl/index.php/rchped/article/downloadSuppFile/3693/10906
dc.relation	http://www.revistachilenadepediatria.cl/index.php/rchped/article/downloadSuppFile/3693/10930
dc.rights	Copyright (c) 2022 Andes Pediatrica	es-ES
dc.source	Revista Chilena de Pediatría; Vol. 93, Núm. 1 (2022): Enero - Febrero; 19-26	en-US
dc.source	Andes Pediatrica; Vol. 93, Núm. 1 (2022): Enero - Febrero; 19-26	es-ES
dc.source	2452-6053
dc.source	2452-6053
dc.subject		en-US
dc.subject	Premature Ovarian Failure; Stem Cell Transplantation; Late Effects; Fertility; Pediatric	en-US
dc.subject		es-ES
dc.subject	Falla Ovárica Prematura; Trasplante de Progenitores Hematopoyéticos; Reserva Ovárica; Fertilidad; Pediatría	es-ES
dc.title	Ovarian reserve and premature ovarian failure in girls and adolescents after hematopoietic stem cell transplantation	en-US
dc.title	Reserva ovárica y falla ovárica prematura en niñas y adolescentes postrasplante de progenitores hematopoyéticos	es-ES
dc.type	info:eu-repo/semantics/article
dc.type	info:eu-repo/semantics/publishedVersion
dc.type		en-US
dc.type		es-ES

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