羟基脲和骨髓移植对镰状细胞贫血女性抗苗勒管激素（AMH）水平的影响。
The effects of hydroxyurea and bone marrow transplant on Anti-Müllerian hormone (AMH) levels in females with sickle cell anemia.
作者信息
Elchuri Swati V, Williamson Rebecca S, Clark Brown R, Haight Ann E, Spencer Jessica B, Buchanan Iris, Hassen-Schilling Leann, Brown Milton R, Mertens Ann C, Meacham Lillian R
机构信息
Emory University School of Medicine, Department of Pediatrics, Division of Endocrinology and Metabolism, 2015 Uppergate Drive, NE Atlanta, GA 30322, USA.
Division of Hematology/Oncology/BMT and Aflac Cancer and Blood Disorders Center of Children's Healthcare of Atlanta, 2015 Uppergate Drive, NE Atlanta, GA 30322, USA.
出版信息
Blood Cells Mol Dis. 2015 Jun;55(1):56-61. doi: 10.1016/j.bcmd.2015.03.012. Epub 2015 Mar 31.
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.
骨髓移植（BMT）后患有镰状细胞贫血（SCA）的男性和女性患者以及接受羟基脲（HU）治疗的男性中存在性腺功能减退。抗苗勒管激素（AMH）是卵巢储备的血清标志物。本研究描述了接受支持性治疗（SCA-SC）、HU（SCA-HU）和BMT（SCA-BMT）的女性SCA受试者的AMH和促卵泡生成素（FSH）水平。招募了年龄在10至21岁、未接受HU治疗、接受HU治疗以及BMT后状态的SCA（SS/Sβ(0)）受试者。SCA-HU受试者接受≥20mg/kg的HU连续治疗≥12个月。SCA-BMT受试者接受了白消安和环磷酰胺治疗。获取血清AMH和随机FSH水平。卵巢储备功能减退（DOR）定义为AMH水平低于年龄匹配对照组的第5百分位数。FSH>40IU/L的受试者也被分类为患有卵巢早衰（POI）。纳入了14名SCA-SC（14.5±2.7岁）、33名SCA-HU（14.4±2.4岁）和9名SCA-BMT（14.3±2.7岁）女性。所有SCA-BMT受试者的AMH均检测不到，24%的SCA-HU受试者的AMH低于第5百分位数。88.9%的SCA-BMT受试者的FSH处于绝经后水平（>40IU/L）。所有SCA-BMT受试者和24%接受HU治疗的受试者存在DOR；89%的SCA-BMT受试者患有POI。AMH和FSH可能是评估卵巢储备和功能的有用工具。
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