leuprolide and Necrosis

Future fertility is a major concern for cancer patients who undergo intensive chemotherapy. There has been controversy about whether hormonal treatments may have protective effects against the severe spermatogenic damage caused by chemotherapy or irradiation. Recently, it has been proposed that gonadotrophin-releasing hormone (GnRH) analogs administered after testicular damage stimulate the recovery of spermatogenesis. In this study, we have investigated the effects of GnRH agonist, leuprorelin, on the damage to spermatogenesis induced by busulfan.. Fisher rats were treated with busulfan, 25 mg/kg, intraperitoneally. The effects of subcutaneous injections of leuprorelin before or after treatment were evaluated histologically 18 weeks later.. The percentage of 'recovered' seminiferous tubules was 27.7 +/- 12.6% in control rats without leuprorelin and 26.9 +/- 10.2% in rats with leuprorelin injected 4 weeks before busulfan. Rats in both groups showed poor recovery of spermatogenesis with an increase of intratesticular fluid. However, rats treated with leuprorelin three times (4 weeks apart) after busulfan showed an improvement of up to 56.5 +/- 12.0% (P < 0.05). A focal but massive necrotic lesion in the testis was observed only in this group of rats.. The results demonstrated that leuprorelin administered after chemical testicular damage enhanced the recovery of spermatogenesis. At the same time, a possible significant side-effect of leuprorelin was noted.

Topics: Animals; Antineoplastic Agents, Alkylating; Atrophy; Busulfan; Gonadotropin-Releasing Hormone; Leuprolide; Male; Necrosis; Rats; Rats, Inbred F344; Regeneration; Seminiferous Tubules; Spermatogenesis; Testis

To define the pathologic changes underlying the mechanism of shrinkage of uterine leiomyomata in patients treated with luprolide acetate.. Retrospective study of pathologic changes seen in leiomyomata removed by hysterectomy or myomectomy in treated and untreated patients, matched by age and size of uteri and leiomyomata.. Gross description and histologic slides of 30 treated and 30 untreated patients.. Histologic examination performed blindly (without knowledge of treatment). Statistical work-up using chi 2 analysis with 1 df.. Degree of hyaline and hydropic degeneration, cellularity, nuclear atypia, necrosis, and obliteration of interface.. Confluent nodular hyaline degeneration representing a scarlike retraction, geographic hydropic degeneration necrosis and obliteration of the interface between myoma and myometrium were found in higher proportions in the treated patients; differences in cellularity, nuclear atypia, and edema were not statistically significant.. The decrease in size of the treated leiomyomata occurs as an accelerated postmenopausal shrinkage because of the antiestrogenic effect of the therapy. Obliterated cleavage planes may explain the difficult enucleation of myomatous nodules in some of the treated patients.

Topics: Adult; Antineoplastic Agents, Hormonal; Female; Humans; Infant, Newborn; Leiomyoma; Leuprolide; Lymphocytes; Middle Aged; Myometrium; Necrosis; Retrospective Studies; Uterine Neoplasms

Recurrence of heavy vaginal bleeding and massive necrosis of a uterine leiomyosarcoma are reported in a 41-year-old female who was being treated with GnRH-a for a presumed uterine fibroid. The pathogenic mechanisms of such an event are reviewed and discussed in light of the available literature on the subject of GnRH-a and the treatment of uterine smooth muscle neoplasms.

Topics: Adult; Female; Humans; Leiomyosarcoma; Leuprolide; Necrosis; Uterine Hemorrhage; Uterine Neoplasms; Uterus