Longitudinal observation of serum anti-Müllerian hormone in three girls after          cancer treatment

Yoko Miyoshi; Kie Yasuda; Makiko Tachibana; Hisao Yoshida; Emiko Miyashita; Takako Miyamura; Yoshiko Hashii; Kae Hashimoto; Tadashi Kimura; Keiichi Ozono

doi:10.1297/cpe.25.119

Original Article

Longitudinal observation of serum anti-Müllerian hormone in three girls after cancer treatment

Yoko Miyoshi, Kie Yasuda, Makiko Tachibana, Hisao Yoshida, Emiko Miyashita, Takako Miyamura, Yoshiko Hashii, Kae Hashimoto, Tadashi Kimura, Keiichi Ozono

Author information

Yoko Miyoshi
Department of Pediatrics, Osaka University Graduate School of Medicine, Osaka, Japan
Kie Yasuda
Department of Pediatrics, Osaka University Graduate School of Medicine, Osaka, Japan
Makiko Tachibana
Department of Pediatrics, Osaka University Graduate School of Medicine, Osaka, Japan
Hisao Yoshida
Department of Pediatrics, Osaka University Graduate School of Medicine, Osaka, Japan
Emiko Miyashita
Department of Pediatrics, Osaka University Graduate School of Medicine, Osaka, Japan
Takako Miyamura
Department of Pediatrics, Osaka University Graduate School of Medicine, Osaka, Japan
Yoshiko Hashii
Department of Pediatrics, Osaka University Graduate School of Medicine, Osaka, Japan
Kae Hashimoto
Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Osaka, Japan
Tadashi Kimura
Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Osaka, Japan
Keiichi Ozono
Department of Pediatrics, Osaka University Graduate School of Medicine, Osaka, Japan

Keywords: anti-Müllerian hormone, childhood cancer survivor, gonadal function, fertility, ovarian reserve

JOURNAL OPEN ACCESS

2016 Volume 25 Issue 4 Pages 119-126

DOI https://doi.org/10.1297/cpe.25.119

Details

Abstract

Gonadal dysfunction and infertility are major endocrinological late effects among childhood cancer survivors. Chemotherapy and radiation have gonadotoxic effects and diminish the ovarian reserve. The serum concentration of anti-Müllerian hormone (AMH) is a useful marker of ovarian reserve in survivors. We conducted a longitudinal study to investigate the variations of AMH in evaluating the acute and chronic effects of cancer therapy on the ovary. Three young female patients with different hematological diseases were registered, and their medical records were reviewed. Patient 1 with myelodysplastic syndrome received reduced-intensity hematopoietic stem cell transplantation (HSCT) at 10 yr of age. Breast development and menarche occurred spontaneously after HSCT; however, AMH level became undetectable and gonadotropin did not increase. Patient 2 with acute lymphoblastic leukemia had been receiving chemotherapy since 11 yr of age. AMH level became undetectable but increased after chemotherapy and was associated with regular menstruation. Patient 3 with acute myeloid leukemia received chemotherapy at 13 yr of age and myeloablative HSCT at 14 yr of age. AMH level became undetectable after HSCT, and the patient developed amenorrhea. These different patterns in the recovery phase demonstrated that the AMH level immediately after the end of cancer therapy is inappropriate for the evaluation of the ovarian reserve.

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