Hormonal replacement therapy in adolescents and young women with chemo- or radio-induced premature ovarian insufficiency: Practical recommendations.

• 影响指数: 10.626
• 发表时间: 01 2021
• 来源期刊: Blood Rev
• DOI: 10.1016/j.blre.2020.100730
• PMID: 32654893
• 文章类型: Journal Article
• 中科院分区: Q2
• 方向: 医学
• 作者列表: Cattoni A,Parissone F,Porcari I,Molinari S,Masera N,Franchi M,Cesaro S,Gaudino R,Passoni P,Balduzzi A

关键词: Bone mineral density; Childhood cancer survivors; Hematopoietic stem cell transplantation; Hormone replacement therapy; Iatrogenic premature ovarian insufficiency; Puberty induction

Mesh: Adolescent; Child; Clinical Decision-Making; Disease Management; Disease Susceptibility; Female; Hormone Replacement Therapy / methods; Humans; Primary Ovarian Insufficiency / etiology therapy; Puberty; Radiation Injuries / etiology therapy

Abstract

In women with premature ovarian insufficiency (POI), hormonal therapy (HT) is indicated to decrease the risk of morbidity and to treat symptoms related to prolonged hypoestrogenism. While general recommendations for the management of HT in adults with POI have been published, no systematic suggestions focused on girls, adolescents and young women with POI following gonadotoxic treatments (chemotherapy, radiotherapy, stem cell transplantation) administered for pediatric cancer are available. In order to highlight the challenging issues specifically involving this cohort of patients and to provide clinicians with the proposal of practical therapeutic protocol, we revised the available literature in the light of the shared experience of a multidisciplinary team of pediatric oncologists, gynecologists and endocrinologists. We hereby present the proposals of a practical scheme to induce puberty in prepubertal girls and a decisional algorithm that should guide the clinician in approaching HT in post-pubertal adolescents and young women with iatrogenic POI.