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Reversible busulfan-induced ovarian failure.

O Shalev¹, G Rahav, A Milwidsky

¹Department of Medicine, Hadassah University Hospital, Mount Scopus, Jerusalem, Israel.

European Journal of Obstetrics, Gynecology, and Reproductive Biology

|November 1, 1987

Summary

Busulfan therapy for chronic myeloid leukemia can cause reversible ovarian failure in women, leading to temporary amenorrhea. This case highlights the potential for fertility recovery despite chemotherapy, emphasizing the need for careful monitoring.

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Area of Science:

Oncology
Reproductive Endocrinology

Background:

Chronic myeloid leukemia (CML) is a myeloproliferative neoplasm.
Chemotherapy, including busulfan, is used to treat CML.
Busulfan can cause significant side effects, including ovarian toxicity.

Purpose of the Study:

To report a case of reversible busulfan-induced ovarian failure in a patient with CML.
To discuss the implications for fertility and pregnancy in CML patients undergoing chemotherapy.

Main Methods:

Case report of a 26-year-old woman with CML.
Hormonal assays (luteinizing hormone, follicle-stimulating hormone, 17 beta-estradiol) to assess ovarian function.
Monitoring of pregnancy status and fetal karyotype via amniocentesis.

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Main Results:

The patient developed amenorrhea and climacteric symptoms consistent with ovarian failure.
Hormonal profile confirmed ovarian failure (elevated gonadotropins, low estradiol).
Amenorrhea reversed, and the patient became pregnant a year later while on busulfan, which was then discontinued.

Conclusions:

Busulfan-induced ovarian failure can be reversible, allowing for subsequent pregnancy.
Fertility preservation and contraception counseling are crucial for women of reproductive age with CML.
Successful pregnancy and delivery of a healthy infant were achieved after busulfan cessation.