PREVENTION OF IRREVERSIBLE CHEMOTHERAPY-INDUCED OVARIAN DAMAGE IN YOUNG-WOMEN WITH LYMPHOMA BY A GONADOTROPIN-RELEASING-HORMONE AGONIST IN PARALLEL TO CHEMOTHERAPY

To examine whether the concomitant administration of a gonadotrophin-r eleasing hormone agonist (GnRHa) during combination chemotherapy to yo ung women with lymphoma may facilitate preservation of gonadal functio n, a prospective clinical protocol was undertaken in 18 cycling women with lymphoma, aged 15-40 years, Thirteen patients suffered from Hodgk in disease (HD) and 5 from non-Hodgkin lymphoma, After informed consen t a monthly injection of depot D-TRP(6)-GnRHa was administered for a m aximum of 6 months starting prior to chemotherapy, Most of these patie nts (15/18) were treated with the MOPP/ABV(D) combination chemotherapy followed by mantle field irradiation in 10 patients, Hormonal profile [luteinizing hormone (LH), follicle stimulating hormone (FSH), oestra diol, testosterone, progesterone, insulin-like growth factor (IGF)-1, prolactin] was taken before the GnRHa/chemotherapy co-treatment, and m onthly thereafter until resuming spontaneous ovulation and menses, Thi s group of prospectively treated lymphoma patients was compared to a m atched control group of 18 women (aged 17-40 years) who have been trea ted with chemotherapy, mostly MOPP/ABV (14/18), with (11) or without ( 7) mantle field radiotherapy, Fourteen had Hodgkin's and four non-Hodg kin's lymphoma, Gonadal function was determined clinically, hormonally (LH, FSH, oestradiol, progesterone), and sonographically. Two of the patients in each group died from refractory disease, Of the remaining 16 patients, 15 (93.7%) resumed spontaneous ovulation and menses withi n 3-8 months of termination of the combined chemotherapy/ GnRHa co-tre atment. In contrast, only seven (39%) of the 18 similarly treated pati ents in the control group (chemotherapy without GnRHa) resumed ovarian cyclic activity (regular menses), The other 11 experienced premature ovarian failure (POF) (61%), Our preliminary data suggest a possible s ignificant protective effect of GnRHa co-treatment with chemotherapy f rom irreversible ovarian damage (POF).