Oncotarget

Research Papers:

Anti-Müllerian hormone levels in patients with gestational trophoblastic neoplasia treated with different chemotherapy regimens: a prospective cohort study

Xiaoning Bi, Jingjing Zhang, Dongyan Cao _, Hengzi Sun, Fengzhi Feng, Xirun Wan, Yang Xiang, Ling Qiu, Xinqi Cheng, Jiaxin Yang and Keng Shen

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Oncotarget. 2017; 8:113920-113927. https://doi.org/10.18632/oncotarget.23027

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Abstract

Xiaoning Bi1, Jingjing Zhang1, Dongyan Cao1, Hengzi Sun1, Fengzhi Feng1, Xirun Wan1, Yang Xiang1, Ling Qiu2, Xinqi Cheng2, Jiaxin Yang1 and Keng Shen1

1Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China

2Department of Clinical Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China

Correspondence to:

Dongyan Cao, email: caodongyan@pumch.cn

Keng Shen, email: shenkeng@pumch.cn

Keywords: anti-Müllerian hormone; gestational trophoblastic neoplasia; follicle-stimulating hormone; chemotherapy

Received: September 01, 2017     Accepted: November 13, 2017     Published: December 06, 2017

ABSTRACT

Purpose: To assess the ovarian reserve of patients with gestational trophoblastic neoplasia (GTN) treated with chemotherapy by evaluating serum anti-Müllerian hormone (AMH) and follicle-stimulating hormone (FSH) levels before, during, and after chemotherapy.

Results: The basal AMH level (mean: 3.98 ± 3.20 ng/mL) negatively correlated with age, while the basal FSH level (mean: 5.71 ± 9.69 mIU/mL) had no correlation with age. After 3 chemotherapy cycles, serum AMH levels decreased and FSH levels increased. The magnitude of the AMH level decline was significantly greater for combination chemotherapy than for single-agent dactinomycin D therapy (61.80% vs. 27.57%) (p = 0.0004) and was higher in patients whose regimens included etoposide (73.69% vs 40.51%) (p = 0.0359). After chemotherapy completion, AMH levels showed a further decline, and cumulative AMH concentration change was associated with doses of vincristine (p = 0.009) and etoposide (p = 0.032). At the 3-month follow-up, AMH levels significantly increased in the dactinomycin D group (p = 0.0067).

Materials and Methods: This prospective study included 34 patients with GTN. Serum AMH and FSH levels were measured before chemotherapy, after the 3rd cycle, and at 2 weeks and 3 months after chemotherapy. Cumulative changes of serum AMH levels in patients who received different chemotherapy regimens were analyzed.

Conclusions: Chemotherapy for GTN affects the ovarian reserve, with substantial differences between chemotherapy protocols. The results improve our understanding of ovarian toxicity and support the use of fertility preservation strategies.


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