Gonadal status following bone marrow transplantation with low dose busulfan-cyclophosphamide regimen

Gonadal dysfunction is one of the short and long-term side effects following bone marrow transplantation (BMT). We assessed hypophyseal-gonadal axis after BMT by low dose busulfan-cyclophosphamide conditioning regimen (120 mg/kg).

In this cohort study, we evaluated gonadal function in 48 patients (25 pubert males and 23 pubert females). Data were obtained by history, physical examination, LH, FSH, prolactin, estradiol (E2), progesterone, testosterone and semen analysis before BMT and in 6 and 12 months of post-BMT.

Gonadal axis in 16 male subjects (64%) was normal before BMT and remained normal in 6 subjects (37%) 12 months post BMT. In another 10 patients (63%), hypogonadism was started in 6 months post BMT. Spermatogenesis failure (31%), low level of testosterone (25%) and spermatogenesis failure plus low level of testosterone in 12.5% were found. Gonadal axis in 20 female subjects (87%) was normal before BMT, but remained normal only in 10% of subject until the end of the study. Other patients (90%) had primary hypogonadism in 6 months of post BMT.

There is a high prevalence of gonadal dysfunction following BMT in both adult sexes (especially in female patients). Therefore, regular gonadal assessment is recommended following BMT.