Abstract
This commentary discusses a paper by Cocco et al. that addresses the treatment of multiple sclerosis (MS) with the drug mitoxantrone in women of childbearing age. This is a very important issue, as mitoxantrone is thought to be associated with the development of chemotherapy-induced amenorrhea (CIA) in women with MS. CIA is a condition characterized by cessation of menstrual bleeding that can be associated with either temporary or permanent infertility. In the study, a clear cumulative dose effect of mitoxantrone on the development of CIA was demonstrated. The risk of CIA was also shown to increase with age. However, the incidence of CIA was lower in women who took estroprogestinic hormones concurrently with mitoxantrone. The authors concluded that mitoxantrone may markedly affect reproductive capacity in women with MS and that estroprogestinic drugs should be administered alongside mitoxantrone to guard against these possible effects. The potential for estroprogestinic drugs to guard against CIA is intriguing and warrants further investigation.
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References
Giesser BS (2002) Gender issues in multiple sclerosis. Neurologist 8: 351–356
Whitacre CC et al. (1999) A gender gap in autoimmunity. Science 283: 1277–1278
Cocco E et al. (2008) Frequency and risk factors of mitoxantrone-induced amenorrhea in multiple sclerosis: the FEMIMS study. Mult Scler 14: 1225–1233
Boskovic R et al. (2005) The reproductive effects of beta interferon therapy in pregnancy: a longitudinal cohort. Neurology 65: 807–811
Di Cosimo S et al. (2004) Incidence of chemotherapy-induced amenorrhea depending on the timing of treatment by menstrual cycle phase in women with early breast cancer. Ann Oncol 15: 1065–1071
Wu TC et al. (1993) Detection of estrogen receptor messenger ribonucleic acid in human oocytes and cumulus-oocyte complexes using reverse transcriptase-polymerase chain reaction. Fertil Steril 59: 54–59
Rau SW et al. (2003) Estradiol attenuates programmed cell death after stroke-like injury. J Neurosci 23: 11420–11426
Tiwari-Woodruff S et al. (2007) Differential neuroprotective and antiinflammatory effects of estrogen receptor (ER)alpha and ERbeta ligand treatment. Proc Natl Acad Sci USA 104: 14813–14818
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Voskuhl, R., Jackson Wu, T. Do estroprogestinic hormones protect against chemotherapy-induced amenorrhea in multiple sclerosis?. Nat Rev Neurol 5, 18–19 (2009). https://doi.org/10.1038/ncpneuro0951
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DOI: https://doi.org/10.1038/ncpneuro0951