A Case of Hypergonadtropic Hypogonadism Following Peripheral Blood Stem Cell Transplantation with Non-TBI Preconditioning Regimen.
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We report on a patient who had undergone peripheral blood-stem cell transplantation (PBSCT) for acute myelogenous leukemia, and whose ovarian function had been impaired for the subsequent two years. The treatment for AML was started according to CCLSG 9205 protocol. Menstruation had been recorded once per month during conventional chemotherapy. PBSCT was performed following the sixth series of chemotherapy. Non-TBI regimen was applied for preconditioning : busulfan 4 mg/kg/day (from day -10 to -7), VP16 50 mg/kg (day -6) and Ara C 3g/m<SUP>2</SUP> twice per day (from day -5 to -2). Her serum LH and FSH showed elevated basal levels, 65 mIU/ml and 151 mIU/ml, respectively, and excess response to LH-RH (peak levels of LH and FSH were 189 mIU/ml and 199 mIU/ml, respectively) at five months after the PBSCT. Amenorreha, elevated basal levels of LH and FSH, and low E<SUB>2</SUB> continued thereafter. Therefore, she was diagnosed as having hypergonadotropic hypogonadism. She complained of vertigo, fatigue and loss of activity after PBSCT, symptoms which are similar to menopausal symptoms. Replacement therapy using estrogen (mestranol) was effective to lessen the symptoms. This case shows that even the non-TBI regimen may cause hypergonadotropic hypogonadism.
- 特定非営利活動法人 日本小児血液・がん学会の論文
特定非営利活動法人 日本小児血液・がん学会 | 論文
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