Lupron to Prevent Menstrual Bleeding or Uterine Bleeding During Cancer Therapy – pro
Patients who are severely thrombocytopenic are at risk of bleeding and when they are female, rendering them amenorrheic is of immediate clinical benefit. Leukemic patients are often rendered amenorrheic to avoid bleeding complicaitons, if the chemotherapy itself does not do so. In endomteriosis, amenorrhea occurrs on Lupron in 74% and 98% of the patients after the first and second treatment months respectively. Most of the remaining patients report episodes of only light bleeding or spotting.
This practice is quite widespread and supported by a number of observational and retrospective studies.
REFERENCES:
Chizuru Kawano-Yamamoto, Kazuo Muroi, Masaki Mori, Tadashi Nagai and Keiya Ozawa, Leuprorelin Acetate for Female Patients with Newly Diagnosed Acute Leukemia Receiving Chemotherapy International Journal of Hematology , Volume 86, Number 2, 199-201, 2002
Lhommé C, Brault P, Bourhis JH, et al. Prevention of menstruation with leuprorelin (GnRH agonist) in women undergoing myelosuppressive chemotherapy or radiochemotherapy for hematological malignancies: a pilot study. Leuk Lymphoma 2001; 42:1033.
Laufer MR, Townsend NL, Parsons KE, et al. Inducing amenorrhea during bone marrow transplantation. A pilot study of leuprolide acetate. J Reprod Med 1997; 42:537.
Meirow D, Rabinovici J, Katz D, et al. Prevention of severe menorrhagia in oncology patients with treatment-induced thrombocytopenia by luteinizing hormone-releasing hormone agonist and depo-medroxyprogesterone acetate. Cancer 2006; 107:1634.
Amsterdam A, Jakubowski A, Castro-Malaspina H, et al. Treatment of menorrhagia in women undergoing hematopoietic stem cell transplantation. Bone Marrow Transplant 2004; 34:363.
Michelle L. MatthewsCancer, Fertility Preservation, and Future Pregnancy: A Comprehensive Review
Obstetrics and Gynecology International Volume 2012 (2012), Article ID 953937, 11 pages
Quaas AM, Ginsburg ES. Prevention and treatment of uterine bleeding in hematologic malignancy. Eur J Obstet Gynecol Reproduct Biol. 2007;134:3-8.
Management of Menorrhagia Associated With Chemotherapy-Induced Thrombocytopenia in Women With Hematologic Malignancy
Jill S. Bates, Pharm.D., M.S., Larry W. Buie, Pharm.D., C. Brock Woodis, Pharm.D.Disclosures
Pharmacotherapy. 2011;31(11):1092-1110.
https://www.acog.org/Clinical-Guidance-and-Publications/Committee-Opinions/Committee-on-Adolescent-Health-Care/Options-for-Prevention-and-Management-of-Heavy-Menstrual-Bleeding-in-Adolescent-Patients-Undergoing, Accessed 8/26/18