Abstract
Ovarian and pituitary-gonadal function was evaluated in 12 women who were treated with cyclophosphamide for nephrotic syndrome before or during puberty. The mean age at the start of treatment was 8.7 years; the mean total dose of cyclophosphamide was 439 mg/kg body weight; and the mean follow-up time was 12.3 years. The investigations included detailed developmental, menstrual and fertility histories; general and gynaecological examinations; basal levels and follicle-stimulating hormone and luteinizing hormone responses to gonadotropin-releasing hormone, and plasma oestradiol determinations. All patients had normal pubertal development and regular menstrual patterns. Two had borne healthy children. Although hormonal studies did not show obvious ovarian or pituitary-gonadal dysfunction, further follow-up is required to ascertain whether the patients with the most prolonged treatment undergo a premature menopause.
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Penso J, Lippe B, Ehrlich R, Smith FG (1974) Testicular function in prepubertal and pubertal male patients treated with cyclophosphamide for nephrotic syndrome. J Pediatr 84: 831–836
Pennisi AJ, Grushkin CM, Lieberman E (1975) Gonadal function in children with nephrosis treated with cyclophosphamide. Am J Dis Child 129: 315–318
Etteldorf JN, West CD, Pitcock JA, Williams DL (1976) Gonadal function, testicular histology, and meiosis following cyclophosphamide therapy in patients with nephrotic syndrome. J Pediatr 88: 206–212
Lentz RD, Bergstein J, Steffes MW, Brown DR, Prem K, Michael AF, Vernier RL (1977) Postpubertal evaluation of gonadal function following cyclophosphamide therapy before and during puberty. J Pediatr 91: 385–394
Hsu AC, Folami AO, Bain J, Rance CP (1979) Gonadal function in males treated with cyclophosphamide for nephrotic syndrome. Fertil Steril 31: 173–177
Watson AR, Rance CP, Bain J (1985) Long-term effects of cyclophosphamide on testicular function. Br Med J 291: 1457–1460
Rance CP, Arbus GS, Balfe JW (1976) Management of the nephrotic syndrome in children. Pediatr Clin North Am 23: 735–750
DeGroot GW, Faiman C, Winter JSD (1974) Cyclophosphamide and the prepubertal gonad. A negative report. J Pediatr 84: 123–125
Parra A, Santos D, Cervantes C, Sojo I, Carranco A, Cortes-Gallegos V (1978) Plasma gonadotropins and gonadal steroids in children treated with cyclophosphamide. J Pediatr 92: 117–124
Watson AR, Taylor J, Rance CP, Bain J (1986) Gonadal function in women treated with cyclophosphamide for childhood nephrotic syndrome: a long-term follow-up study. Fertil Steril 46: 331–333
Koyama H, Wada T, Nishizawa Y, Iwanaga T, Aoki Y, Terasawa T, Kosaki G, Yamamoto T, Wada A (1977) Cyclophosphamide-induced ovarian failure and its therapeutic significance in patients with breast cancer. Cancer 39: 1403–1409
Chapman RM, Sutcliffe SB, Malpas JS (1979) Cytotoxic-induced ovarian failure in women with Hodgkin's disease. I. Hormone function. JAMA 242: 1877–1881
Arbeitsgemeinschaft für Pädiatrische Nephrologie (1982) Effect of cytotoxic drugs in frequently relapsing nephrotic syndrome with and without steroid dependence. N Engl J Med 306: 451–454
Kletzky OA, Nakamura RM, Thorneycroft IH, Mishell DR (1975) Log normal distributions of gonadotropins and ovarian steroid values in the normal menstrual cycle. Am J Obstet Gynecol 121: 688–694
Soule MR, Jeloysek FR, Wiebe RH, Tyrey L, Paulson DF, Hammond CB (1979) Amenorrhea: observations based on the analysis of luteinizing hormone-releasing hormone testing. Am J Obstet Gynecol 135:651–662
Cvetković R, Radmanović S, Bunjevački G, Cvetković P (1978) Time of appearance of menarche in secondary school girls in Belgrade (Vreme pojave meharhe u devojčica srednjih škola u Beogradu) in: Proceedings of the XV meeting of Paediatric Association of Bosnia and Herzegovina (Zbornik radova, XV pedijatrijski dani Bosne i Hercegovine), Medical Association of Bosnia and Herzegovina, Visoko, pp. 57–60
Population census, houshoids, and dwellings in 1981. Tables No 049 and 103 (Popis stanovnìštva, domaćinstava i stanova 1981; tabele br. 049 i 103) (1984) Federal Statistical Office (Savezni zavod za statistiku), Belgrade.
Yen SSC, VandenBerg G, Rebar R, Ehara Y (1972) Variation of pituitary responsiveness to synthetic LRF during different phases of the menstrual cycles. J Clin Endocrinol Metab 35: 931–934
Arbeitsgemeinschaft für Pädiatrische Nephrologie (1987) Cyclophosphamide treatment of steroid dependent nephrotic syndrome: comparison of eight week with 12 week course. Arch Dis Child 62: 1102–1106
Jackson H (1964) The effects of alkylating agents on fertility. Br Med Bull 20: 107–114
Uldall PR, Kerr DNS, Tacchi D (1972) Sterility and cyclophosphamide. Lancet I: 693–694
Kumar R, Biggart JD, McEvoy J, McGeown MG (1972) Cyclophosphamide and reproductive function. Lancet I: 1212–1214
Arneil GC (1972) Cyclophosphamide and the prepubertal testis. Lancet II: 1259–1260
Miller JJ, Williams GF, Leissring JC (1971) Multiple late complications of therapy with cyclophosphamide, including ovarian destruction. Am J Med 50: 530–535
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Bogdanović, R., Banićević, M. & Čvorić, A. Pituitary-gonadal function in women following cyclophosphamide treatment for childhood nephrotic syndrome: long-term follow-up study. Pediatr Nephrol 4, 455–458 (1990). https://doi.org/10.1007/BF00869819
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DOI: https://doi.org/10.1007/BF00869819