白血病化疗及造血干细胞移植对卵巢功能的影响

目的 研究造血干细胞移植对卵巢功能的影响。方法 观察45例因急性非淋巴细胞白血病分别接受同种异体造血干细胞移植（Allogeneic stem cell transplantation，Allo-SCT）和自体造血干细胞移植（Autologous stem cell transplantation，Auto-SCT）患者的月经恢复情况和性激素变化，同时抽取45名同年龄段健康妇女作为对照。结果 Allo-SCT组有2例患者月经恢复，Auto-SCT组有4例恢复；移植时年龄越小，卵巢功能越易恢复。Allo-SCT和Auto-SCT后促性腺激素较对照组显著升高，而雌激素显著降低，Allo-SCT患者雄激素也显著降低。结论 造血干细胞移植后引起的卵巢功能降低主要是因为移植前化疗对卵巢的损害，但Allo-SCT引起的免疫调节障碍可进一步使卵巢功能减退。

The Effect of Leukemic Chemotherapy and Stem Cell Transplantation on Ovarian Function

Objective To study the influence of stem cell transplantation on the ovarian function. Methods The positive predictors of menstrual cycles recovery and the alteration of hormone were studied in the reproductive age of women after Allo - SCT or Auto - SCT, and compared with hormone of the normal reproductive age of 45 women. Results Menstrual cycles recovered in two and four women in the Allo - SCT and Auto - SCT groups respectively, being associated with younger age. Significantly, the higher gonadotrophin levels and lower estradiol were seen in the patients than in controls. In Allo - transplanted women, androgens were also significantly lower than those in controls. Conclusion Ovarian failure in SCT recipients is likely to be caused principally by myelo- ablative treatments, but the ovarian function can be worsened by an altered immunomodulation in Allo - SCT.