The effects of hydroxyurea and bone marrow transplant on Anti-Müllerian hormone (AMH) levels in females with sickle cell anemia

• Published in: Blood cells, molecules, & diseases molecules, & diseases, 2015-06, Vol.55 (1), p.56-61
• Main Authors: 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.
• Format: Article
• Language: English
• Subjects: Adolescent; Anemia, Sickle Cell - blood; Anemia, Sickle Cell - complications; Anemia, Sickle Cell - diagnosis; Anemia, Sickle Cell - therapy; Anti-Mullerian Hormone - blood; Anti-Müllerian hormone; Antisickling Agents - therapeutic use; Biomarkers - blood; Bone marrow transplant; Bone Marrow Transplantation; Busulfan - therapeutic use; Case-Control Studies; Child; Cyclophosphamide - therapeutic use; Diminished ovarian reserve; Female; Follicle Stimulating Hormone - blood; Hemoglobin, Sickle - metabolism; Heterozygote; Homozygote; Humans; Hydroxyurea; Hydroxyurea - therapeutic use; Menarche - physiology; Myeloablative Agonists - therapeutic use; Ovarian Reserve - drug effects; Premature ovarian insufficiency; Primary Ovarian Insufficiency - blood; Primary Ovarian Insufficiency - complications; Primary Ovarian Insufficiency - diagnosis; Primary Ovarian Insufficiency - therapy; Young Adult
• ISSN: 1079-9796; 1096-0961
• DOI: 10.1016/j.bcmd.2015.03.012

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/Sβ0) subjects not on HU, on HU and status-post BMT, ages 10–21years were recruited. SCA-HU subjects were treated with HU≥20mg/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 40IU/L were classified as having premature ovarian insufficiency (POI). 14 SCA-SC (14.5±2.7years), 33 SCA-HU (14.4±2.4years) and 9 SCA-BMT (14.3±2.7years) females were included. AMH was undetectable in all SCA-BMT subjects and 40IU/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.