Hormone therapy for premature ovarian insufficiency patients with malignant hematologic diseases

Abstract

Objectives: The current usage of hormone therapy (HT) among perimenopausal women is low in China, especial in women with premature ovarian insufficiency (POI) with malignant hematologic diseases. This study investigated the efficacy and safety of HT in POI patients with malignant hematologic diseases who have received myeloablative chemotherapy and hemopoietic stem cell transplantation (HSCT).

Methods: Patients who had POI after myeloablative chemotherapy and HSCT for malignant hematologic diseases were enrolled. Questionnaires with information about characteristics, menstrual status, sex hormone levels and menopausal symptoms were used to evaluate the relief from menopausal symptoms and safety of HT.

Results: Among 130 cases, 103 (79.2%) patients had perimenopausal symptoms. The mean total Kupperman menopausal index score changed significantly from 13.50 ± 7.128 to 6.13 ± 5.97 after HT for 24 months. Among the 118 patients who received estrogen/progestin cyclic sequential therapy, 89 (75.4%) had withdrawal bleeding.

Conclusion: Myeloablative chemotherapy against leukemia may cause POI. HT may relieve perimenopausal symptoms after myeloablative chemotherapy and HSCT. HT was safe and no excessive recurrences or mortality were seen in the hormone-treated group for patients who survived from malignant hematologic diseases and who received HSCT.

Keywords:

• Premature ovarian failure
• hormone therapy
• leukemia
• myeloablative chemotherapy
• hemopoietic stem cell transplantation

Acknowledgements

The authors would like to acknowledge Dr Anuradha Nalli and Dr Amit Bhat (Indegene Private. Ltd., Bangalore) for providing medical writing assistance and editorial support in the preparation of the manuscript.

Conflict of interest

The authors report no conflict of interest. The authors alone are responsible for the content and writing of this paper.

Source of funding

This study was supported by the Capital clinical application characteristic study: The standardization of hormone therapy for the iatrogenic premature ovarian (Project no. Z121107001012031).