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Breast. 2017 Oct;35:130-135. doi: 10.1016/j.breast.2017.07.007. Epub 2017 Jul 18.

Anti-Müllerian hormone (AMH) levels in premenopausal breast cancer patients treated with taxane-based adjuvant chemotherapy - A translational research project of the SUCCESS A study.

Author information

1
Department of Gynecology and Obstetrics, University Hospital, Ludwig-Maximilians-University, Maistrasse 11, 80337, Munich, Germany; Department of Gynecology and Obstetrics, University Hospital Graz, Medical University of Graz, Auenbruggerplatz 14, 8036, Graz, Austria.
2
Department of Gynecology and Obstetrics, University Hospital, Ludwig-Maximilians-University, Maistrasse 11, 80337, Munich, Germany.
3
Kinderwunschzentrum Altonaer Straße, Altonaer Strasse 59, 20357, Hamburg, Germany.
4
Department of Gynecology and Obstetrics, Ulm University Hospital, Prittwitzstrasse 43, 89075, Ulm, Germany.
5
Centrum for Hematology and Oncology Bethanien, Im Prüfling 17-19, 60389, Frankfurt/Main, Germany.
6
National Center for Tumor Diseases, University Hospital Heidelberg, Im Neuenheimer Feld 460, 69120, Heidelberg, Germany.
7
Department of Obstetrics and Gynecology, Friedrich-Alexander University Erlangen-Nuremberg, Comprehensive Cancer Center Erlangen-Nuremberg, Schloßplatz 4, 91054, Erlangen, Germany.
8
Department of Gynecology, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany. Electronic address: v.mueller@uke.de.

Abstract

BACKGROUND:

Premenopausal women undergoing chemotherapy are at high risk for premature ovarian failure and its long-term consequences. Data on potential markers to evaluate ovarian reserve pre- and posttreatment are limited. Anti-Müllerian hormone (AMH) known for ovarian reserve in reproductive medicine could be a surrogate marker and was assessed in premenopausal breast cancer patients of the SUCCESS A study (EUDRA-CT no. 2005-000490-21).

METHODS:

We identified 170 premenopausal patients, age ≤ 40 years at trial entry, who received FEC-Doc as taxane-anthracylince based chemotherapy. Blood samples were taken at three time points: Before, four weeks after and two years after adjuvant chemotherapy. Serum AMH-levels were evaluated in a central laboratory by a quantitative immunoassay AMH Gen II ELISA (Beckman Coulter, Brea, USA).

RESULTS:

Median age was 36 years (21-40 years). Median serum AMH-level before chemotherapy was 1.37 ng/ml (range < 0.1-11.3 ng/ml). Four weeks after chemotherapy AMH-levels dropped in 98.6% of the patients to <0.1 ng/ml (range < 0.1-0.21 ng/ml). After two years, 73.3% (n = 101) showed no evidence of ovarian function recovery (AMH <0.1 ng/ml, range < 0.1-3.9 ng/ml). Permanent chemotherapy induced amenorrhea occurred only in 50.6% of the patients.

CONCLUSIONS:

In this analysis, premenopausal patients showed a high rate of ovarian impairment reflected by low AMH-levels after chemotherapy.

KEYWORDS:

Anti-mullerian hormone; Breast cancer; Chemotherapy; Ovarian reserve; Premenopausal; Taxane

PMID:
28732324
DOI:
10.1016/j.breast.2017.07.007
[Indexed for MEDLINE]

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