Ovarian function after bone marrow transplantation performed before menarche
a Department of
Pediatrics, Tokai University School of Medicine, Bohseidai,
Isehara-shi, Kanagawa-ken 259-1193, Japan, b Research Center for Genetic Engineering and
Cell Transplantation, Tokai University School of Medicine
Correspondence to: Dr Shinohara. email: oshinoha{at}is.icc.u-tokai.ac.jp
Accepted 26 January
1999
AIM
To examine the
long term effect of bone marrow transplantation (BMT) on ovarian
function in girls.
METHODSEighteen girls
who underwent BMT before menarche, had been disease free for more than
six years, and were over 14 years of age at the time of study were
investigated. The preparative regimen consisted of irradiation and
chemotherapy. The occurrence of menarche and changes in basal serum
follicle stimulating hormone (FSH) concentrations were studied.
RESULTSTwelve
patients achieved menarche at a median age of 12.8 years. Age at
transplant was significantly younger in patients who achieved menarche
than in those who did not (mean (SD), 7.2 (0.5) v
11.1 (1.7) years). Basal FSH began to rise to menopausal
concentrations after 10 years of age, and the girls who did not
experience menarche had a sustained rise in FSH concentrations. Among
those with raised FSH concentrations, five girls experienced menarche
while serum FSH values were decreasing and four achieved menarche while
FSH remained raised.
CONCLUSIONSThe high
incidence of menarche suggests a favourable outcome of ovarian function
in girls who undergo BMT at a young age.
Keywords: bone marrow transplantation; gonadotropins; gonadal failure; menstruation
© 1999 by Archives of Disease in Childhood
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