Background and aims: Autologous haematopoietic stem cell transplantation (AHSCT) is a treatment option for aggressive multiple sclerosis (aMS) with an acceptable safety profile, but few data are available so far on its impact on fertility. Methods: Data on menses recovery following transplant and endocrine assessment (luteinizing hormone, folliclestimulating hormone, oestradiol, progesterone, prolactin, testosterone, anti-müllerian hormone - AMH) were collected in aMS patients treated with AHSCT who had at least one endocrine assessment after transplant. Results: 23 females and six males were included (table 1). After conditioning, 19/23 (83%) females experienced persistent amenorrhea. Four females showed spontaneous menses recovery within six months after transplant; these cases were younger compared to those who did not: median age at AHSCT 26 (range 24–39) vs 38 years (26–50), p=0.027. AMH was aligned with values expected according to patients’ age in 8/9 evaluable cases (89%) at baseline, while at month six it decreased to levels below normal values in 7/9 cases (78%); a further reduction at month 24 was observed in 6/7 (86%) cases. Post-transplant AMH was normal in 2/14 (14%) females for whom only post-treatment assessment was available. No pregnancies were reported. In males, post-AHSCT testosterone levels were within the normal range in 5/6 cases and were not reduced compared to baseline in 2/3 (67%) evaluable cases. Conclusion: Although exploratory, our data confirm that AHSCT deeply affects gonadal function in females, with the deepest effect in older women; a potential additive effect of prior immunosuppressive treatments cannot be ruled out. Gonadal function in males seems to be only minimally affected.

Impact of autologous haematopoietic stem cell transplantation on fertility in aggressive multiple sclerosis / A Mariottini, C Innocenti, G Rastrelli, L Vignozzi, A Giachi, R Saccardi, L Massacesi, A Repice. - In: EUROPEAN JOURNAL OF NEUROLOGY. - ISSN 1351-5101. - ELETTRONICO. - 28 supplement 1:(2021), pp. 384-384.

Impact of autologous haematopoietic stem cell transplantation on fertility in aggressive multiple sclerosis

A Mariottini;G Rastrelli;L Vignozzi;R Saccardi;L Massacesi;A Repice
2021

Abstract

Background and aims: Autologous haematopoietic stem cell transplantation (AHSCT) is a treatment option for aggressive multiple sclerosis (aMS) with an acceptable safety profile, but few data are available so far on its impact on fertility. Methods: Data on menses recovery following transplant and endocrine assessment (luteinizing hormone, folliclestimulating hormone, oestradiol, progesterone, prolactin, testosterone, anti-müllerian hormone - AMH) were collected in aMS patients treated with AHSCT who had at least one endocrine assessment after transplant. Results: 23 females and six males were included (table 1). After conditioning, 19/23 (83%) females experienced persistent amenorrhea. Four females showed spontaneous menses recovery within six months after transplant; these cases were younger compared to those who did not: median age at AHSCT 26 (range 24–39) vs 38 years (26–50), p=0.027. AMH was aligned with values expected according to patients’ age in 8/9 evaluable cases (89%) at baseline, while at month six it decreased to levels below normal values in 7/9 cases (78%); a further reduction at month 24 was observed in 6/7 (86%) cases. Post-transplant AMH was normal in 2/14 (14%) females for whom only post-treatment assessment was available. No pregnancies were reported. In males, post-AHSCT testosterone levels were within the normal range in 5/6 cases and were not reduced compared to baseline in 2/3 (67%) evaluable cases. Conclusion: Although exploratory, our data confirm that AHSCT deeply affects gonadal function in females, with the deepest effect in older women; a potential additive effect of prior immunosuppressive treatments cannot be ruled out. Gonadal function in males seems to be only minimally affected.
A Mariottini, C Innocenti, G Rastrelli, L Vignozzi, A Giachi, R Saccardi, L Massacesi, A Repice
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2158/1287017
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