Thread: Hormonal treatment protects against cyclophosphamide-induced gonadal damage

Hormonal treatment protects against cyclophosphamide-induced gonadal damage

Last Updated: 2008-11-27 9:45:22 -0400 (Reuters Health)

NEW YORK (Reuters Health) - For patients being treated with cyclophosphamide for glomerulonephritis, testosterone (for men) and the gonadotropin-releasing hormone analogue triptorelin (for women) protects against associated gonadal damage, according to a report in the November American Journal of Kidney Diseases.

"Clinicians who look after patients undergoing cyclophosphamide therapy should take into consideration this gonadal-protection protocol, which proved to be feasible, effective, and safe and could prevent some patients from declining treatment with cyclophosphamide out of concerns about fertility," Dr. Alessandro Cigni from University of Sassari, Italy, told Reuters Health.

Dr. Cigni and colleagues studied the possible protective effect of testosterone and triptorelin in 11 men and 17 women receiving cyclophosphamide therapy for various forms of glomerulonephritis.

Men's sperm counts fell during immunosuppressive therapy but increased progressively at 6 and 12 months after completing therapy, the authors report. Sperm counts and FSH levels at 12 months were normal for all but one man.

Not all the women received triptorelin; 4 of the 13 received only cyclophosphamide.

All women became amenorrheic during treatment with cyclophosphamide, the researchers note, but all women who received triptorelin resumed menstruation after cessation of therapy, and all experienced ovulatory cycles by the end of follow-up at 18 months.

In contrast, women who did not receive triptorelin developed sustained amenorrhea for more than 12 months.

All 6 women treated with triptorelin who wanted to become pregnant after cessation of treatment conceived without using fertilization techniques and delivered healthy babies at term without congenital anomalies or perinatal illnesses, the investigators say.

"Data from the present study are indicative of a protective effect of testosterone and triptorelin administration on cyclophosphamide-induced gonadal damage in men and women with various forms of nephritis," the authors conclude.

"Our protocol can be used on all patients with glomerulonephritis who have no contraindications," Dr. Cigni added.

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For your ready Reference:cyclophosphamide therapy

Description

Cyclophosphamide belongs to the group of medicines called alkylating agents. It is used to treat cancer of the ovaries, breast, blood and lymph system, nerves (found primarily in children), retinoblastoma (a cancer of the eye found primarily in children), multiple myeloma (cancer in the bone marrow), and mycosis fungoides (tumors on the skin).

Cyclophosphamide is also used for treatment of some kinds of kidney disease.

Cyclophosphamide may also be used for other conditions as determined by your doctor.

Cyclophosphamide interferes with the growth of cancer cells, which are eventually destroyed. Since the growth of normal body cells may also be affected by cyclophosphamide, other effects will also occur. Some of these may be serious and must be reported to your doctor. Other effects, like hair loss, may not be serious but may cause concern. Some effects may not occur for months or years after the medicine is used.


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Cyclophosphamide (Oral Route, Intravenous Route) - MayoClinic.com

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A recent meta-analysis published in the February issue of
the American Journal of Kidney Diseases strengthens this
conclusion.21 The use of cyclophosphamide did not significantly
reduce the risk of ESRD or death.


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http://www.zuidencomm.nl/njm/getpdf.php?id=332
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