Dann Eldad J, Epelbaum Ron, Avivi Irit, Ben Shahar Menachem, Haim Nissim, Rowe Jacob M, Blumenfeld Zeev
Department of Hematology and Bone Marrow Transplantation, Rambam Medical Center & Bruce Rapaport Faculty of Medicine, Technion, Haifa, Israel 31096.
Hum Reprod. 2005 Aug;20(8):2247-9. doi: 10.1093/humrep/dei018. Epub 2005 Apr 7.
Intensive chemotherapy is widely used to improve the outcome of aggressive non-Hodgkin lymphoma (NHL). Since these regimens may cause premature ovarian failure (POF), the ovarian function was studied in 13 consecutive women aged < or =40 years, treated with four cycles of intensified CHOP (cyclophosphamide 2000-3000 mg/m2 per cycle doxorubicin 50 mg/m2, vincristine 1.4 mg/m2 (maximum 2 mg) and prednisone 100 mg/day were given every 3 weeks).
Patients aged <60 years with aggressive NHL were eligible for participating in a non-randomized phase II study if they had stage I, II, B, bulky, or stages III, IV disease with the age-adjusted international prognostic index of low-intermediate to high-risk score. Seven patients were concomitantly treated with D-TRP6-GnRH analogue (Decapeptyl; Ferring, Germany) for minimizing gonadal toxicity.
With a median follow-up of 70 months only one patient had POF, while 12 patients retained fertility and eight conceived spontaneously delivering 12 healthy babies.
It appears that high-dose cyclophosphamide does not affect the ovarian function or fertility in patients exposed to this medication during four consecutive cycles of intensified CHOP.
强化化疗被广泛用于改善侵袭性非霍奇金淋巴瘤（NHL）的治疗效果。由于这些方案可能导致卵巢早衰（POF），我们对13名年龄≤40岁的连续女性进行了卵巢功能研究，她们接受了四个周期的强化CHOP方案治疗（每3周给予环磷酰胺2000 - 3000mg/m²、多柔比星50mg/m²、长春新碱1.4mg/m²（最大2mg）和泼尼松100mg/天）。
年龄＜60岁、患有侵袭性NHL的患者，如果处于I期、II期、B期、肿块型，或年龄调整国际预后指数为低中危至高风险评分的III期、IV期疾病，则有资格参加一项非随机II期研究。7名患者同时接受D - TRP6 - GnRH类似物（曲普瑞林；德国辉凌）治疗，以尽量减少性腺毒性。
中位随访70个月时，只有1名患者出现卵巢早衰，而12名患者保留了生育能力，其中8名自然受孕并产下12名健康婴儿。
在连续四个周期的强化CHOP治疗期间接触该药物的患者中，高剂量环磷酰胺似乎不会影响卵巢功能或生育能力。
