Ovarian function after successful bone marrow transplantation in postmenarcheal females

Ovarian function was followed serially in a group of six postmenarcheal females after successful bone marrow transplantation (BMT). The patients were between 13 9/12 and 22 6/12 (median 16 5/12) years of age at the time of BMT and were followed a median of 20 months (range 17‐45 months) posttransplantation. Two subjects received short‐term high‐dose cyclophosphamide combined with single‐dose total lymphoid irradiation (Group I), whereas the remaining four were treated with short‐term, high‐dose chemotherapy plus single‐dose total body irradiation (Group II). Group II subjects also received combination chemotherapy prior to BMT. One subject from Group I continues to have regular menses and normal gonadotropin levels, 36 months post‐BMT. The remaining five patients have demonstrated persistently elevated plasma concentrations of LH and FSH over a 17‐ to 45‐month period of time. None of the four patients in Group II has menstruated since undergoing BMT. We conclude that single‐dose radiation combined with short‐term, high‐dose chemotherapy results in profound ovarian damage in the majority of young women undergoing BMT.