Inducing amenorrhea during bone marrow transplantation. A pilot study of leuprolide acetate
Laufer, M.R.; Townsend, N.L.; Parsons, K.E.; Brody, K.A.; Diller, L.R.; Emans, S.J.; Guinan, E.C.
Journal of Reproductive Medicine 42(9): 537-541
1997
ISSN/ISBN: 0024-7758 PMID: 9336747 Document Number: 483162
OBJECTIVE: To evaluate, in a pilot study, the use and efficacy of a gonadotropin-releasing hormone (GnRH)- agonist in inducing amenorrhea in women undergoing BMT. STUDY DESIGN: We evaluated the use of the GnRH agonist leuprolide acetate (LA) for the induction of amenorrhea in 10 post-menarcheal women prior to BMT. If there was a contraindication to the use of the intramuscular (IM) formulation of LA, the subcutaneous (SC) formulation was given as a daily intravenous (IV) bolus. Once the subject's platelet count was gt 50,000/mu-L, the LA was discontinued. Menstrual bleeding, time from initiation of therapy to amenorrhea, and liver function test results were monitored. RESULTS: All subjects had induction of amenorrhea with the use of LA except for one subject with a large, myomatous uterus, who experienced light spotting. One subject who was thrombocytopenic at the prescribed time of the second dosage of IM LA received IV LA with documentation of continued pituitary/gonadal suppression. No adverse effects were determined to be directly related to either the IM or IV LA. CONCLUSION: LA is an option for the induction of amenorrhea in post-menarcheal women undergoing BMT. In thrombocytopenic subjects, administration of the SC formulation of LA by an IV route served as an alternative to IM injection and was documented to maintain gonadotropin suppression.