The effects of hydroxyurea and bone marrow transplant on Anti-Müllerian hormone (AMH) levels in females with sickle cell anemia.

Abstract

Gonadal hypofunction is described in male and female patients with sickle cell anemia (SCA) after bone marrow transplant (BMT) and in males treated with hydroxyurea (HU). Anti-Müllerian hormone (AMH) is a serum marker of ovarian reserve. This study describes AMH and follicle-stimulating hormone (FSH) levels in female SCA subjects treated with supportive care (SCA-SC), HU (SCA-HU) and BMT (SCA-BMT). SCA (SS/Sβ(0)) subjects not on HU, on HU and status-post BMT, ages 10-21 years were recruited. SCA-HU subjects were treated with HU ≥ 20 mg/kg for ≥ 12 consecutive months. SCA-BMT subjects had received busulfan and cyclophosphamide. Serum AMH and random FSH levels were obtained. Diminished ovarian reserve (DOR) was defined as AMH level <5th percentile for age-matched controls. Subjects also with FSH >40 IU/L were classified as having premature ovarian insufficiency (POI). 14 SCA-SC (14.5 ± 2.7 years), 33 SCA-HU (14.4 ± 2.4 years) and 9 SCA-BMT (14.3 ± 2.7 years) females were included. AMH was undetectable in all SCA-BMT subjects and <5th percentile in 24% of SCA-HU subjects. FSH was menopausal (>40 IU/L) in 88.9% of SCA-BMT subjects. All SCA-BMT subjects and 24% of subjects on HU had DOR; 89% of SCA-BMT subjects had POI. AMH and FSH may be useful tools in assessing ovarian reserve and function.

• Authors: Swati V Elchuri, Rebecca S Williamson, R Clark Brown, Ann E Haight, Jessica B Spencer, Iris Buchanan, Leann Hassen-Schilling, Milton R Brown, Ann C Mertens, Lillian R Meacham
• Journal: Blood cells, molecules & diseases (Blood Cells Mol Dis) Vol. 55 Issue 1 Pg. 56-61 (Jun 2015) ISSN: 1096-0961 [Electronic] United States
• PMID: 25976468 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2015 Elsevier Inc. All rights reserved.

Chemical References

• Antisickling Agents
• Biomarkers
• Hemoglobin, Sickle
• Myeloablative Agonists
• Anti-Mullerian Hormone
• Cyclophosphamide
• Follicle Stimulating Hormone
• Busulfan
• Hydroxyurea

Topics

• Adolescent
• Anemia, Sickle Cell (blood, complications, diagnosis, therapy)
• Anti-Mullerian Hormone (blood)
• Antisickling Agents (therapeutic use)
• Biomarkers (blood)
• Bone Marrow Transplantation
• Busulfan (therapeutic use)
• Case-Control Studies
• Child
• Cyclophosphamide (therapeutic use)
• Female
• Follicle Stimulating Hormone (blood)
• Hemoglobin, Sickle (metabolism)
• Heterozygote
• Homozygote
• Humans
• Hydroxyurea (therapeutic use)
• Menarche (physiology)
• Myeloablative Agonists (therapeutic use)
• Ovarian Reserve (drug effects)
• Primary Ovarian Insufficiency (blood, complications, diagnosis, therapy)
• Young Adult