Prevention of hypermenorrhea with leuprolide in premenopausal women undergoing bone marrow transplantation

Richard Ghalie, Carlene Porter, Eva Radwanska, William E. Fitzsimmons, Carol M. Richman, Herbert Kaizer
In: American Journal of Hematology · 1993 · vol. 42(4) , pp. 350–353 · doi:10.1002/ajh.2830420404 · PMID:8493984 · W2140450399
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Leuprolide effectively prevented menstrual bleeding in 73% of premenopausal women undergoing bone marrow transplantation, with success rates higher when treatment began at least two weeks before thrombocytopenia.

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Abstract

We report on the use of leuprolide to prevent heavy menstrual bleeding that often occurs before platelet engraftment in premenopausal women undergoing bone marrow transplantation (BMT). Leuprolide, a synthetic analog of gonadotropin-releasing hormone (Gn-RH-a), was given to 34 patients by intravenous bolus injection, 1 mg daily, until platelet recovery. The median duration of therapy was 50 days (range 16-170). When necessary, patients self-administered the drug after discharge from the hospital. No adverse effects could be related directly to the use of leuprolide. Leuprolide effectively prevented menstruation in 25 patients (73%), failed in seven (21%), and two patients were not evaluable. The success of leuprolide therapy was related to the time of onset of treatment, as anticipated from the gradual effect of Gn-RH-a on the menstrual cycle. The failure rate was only 6% (one of 16 patients) when leuprolide was started at least 2 weeks prior to the development of thrombocytopenia, compared to a failure rate of 33% (six of 18 patients) when leuprolide was started at a later time. We conclude that leuprolide as a single agent is a safe and effective method to prevent menstrual bleeding during BMT. Additional studies are needed to determine the best timing for the onset of therapy and the relative benefit of leuprolide compared to other prophylactic approaches in patients with lengthy thrombocytopenia.

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