Post-treatment anti-Mullerian hormone (AMH) levels predict long-term ovarian dysfunction in women with hematological malignancies

Figures & data

Table 1. Clinical characteristics and treatment data of the patients.

Characteristic
Median age (years)	32 (18–40)
Body mass index (kg/m^2)	21.41 (16.3–31.7)
Types of malignancy, number (%)
- Acute myeloid leukemia - Hodgkin lymphoma - Diffuse large B cell lymphoma - Primary mediastinal B cell lymphoma - Follicular lymphoma	9 (31.1) 11 (37.9) 3 (10.4) 5 (17.2) 1 (3.4)
Therapeutic regimens, number (%)
- Induction of chemotherapy for AML then consolidation - Allogeneic stem cell transplantation - R-CHOP/R-DA-EPOCH - ABVD only - ABVD + other regimens - Other regimens	4 (13.8) 5 (17.2) 8 (27.6) 8 (27.6) 3 (10.4) 1 (3.4)
Staging of lymphoma (Ann Arbor staging), number (%)
- Stage I - Stage II - Stage III-IV	10 (50.0) 8 (40.0) 2 (10.0)
Risk stratification for AML, number (%)
- Intermediate risk - Unfavorable risk	5 (55.5) 4 (44.5)

R-CHOP, rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone; R-DA-EPOCH, etoposide, prednisone, vincristine, cyclophosphamide, doxorubicin, and rituximab; ABVD, doxorubicin, bleomycin, vinblastine, and dacarbazine.

Figure 1. Longitudinal changes in hormone levels among patients with hematologic malignancies compared to those of age-matched healthy controls. The dot lines indicated median ± interquartile range. AMH, Anti-Mullerian hormone; FSH, Follicle stimulating hormone; LH, Luteinizing hormone.

Figure 2. Hormone levels of patients classified by treatment modalities. The lines in the indicated median and the boxes indicated interquartile ranges. AMH, Anti-Mullerian hormone; FSH, Follicle stimulating hormone; LH, Luteinizing hormone; CMT, Chemotherapy; SCT, Stem cell transplantation.

Table 2. Hormone levels of patients compared with age-matched healthy controls.

Hormone levels	Patients*	Controls*	P value
AMH level (ng/mL)
- 3 months - 6 months - 12 months	1.6 (0.0–4.2) 0.3 (0–1.8) 1.0 (0.18–1.8)	2.2 (1.8–4.8)	.06 .004 <.001
Estradiol level (pg/mL)
- 3 months - 6 months - 12 months	55.6 (0–112.3) 52.9 (0–154.4) 63.5 (0–246)	56.7 (44.1–110.0)	.3 .7 .9
FSH level (IU/L)
- 3 months - 6 months - 12 months	8.2 (4.2–91.0) 8.4 (5.0–90.0) 7.1 (5.2–9.8)	4.3 (2.2–5.0)	.01 .02 <.001
LH level (IU/L)
- 3 months - 6 months - 12 months	8.6 (4.8–47.9) 8.2 (1.8–37.2) 8.4 (4.1–15.0)	4.7(3.6–7.6)	.08 .3 .02

*Data were shown as median (interquartile ranges). AMH, Anti-Mullerian hormone; FSH, Follicle stimulating hormone; LH, Luteinizing hormone

Figure 3. Serum Anti-Mullerian hormone (AMH) levels and its clinical relevance A. Pie charts showing received treatments. The patient groups were classified according to their 12-month AMH levels B. Association of hormone levels and patient long-term outcomes.