Quaas, A.M., & Ginsburg, E.S. (2007). Prevention and treatment of uterine bleeding in hematologic malignancy. European Journal of Obstetrics & Gynecology and Reproductive Biology, 134, 3–8.
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Purpose
Search Strategy
Literature Evaluated
Sample Characteristics
- FINAL NUMBER STUDIES INCLUDED = 4
- TOTAL PATIENTS INCLUDED IN REVIEW = 94
- KEY SAMPLE CHARACTERISTICS: All four studies reviewed the application of leuprolide acetate (LA) at varying doses and timing in premenopausal females undergoing bone marrow transplant (44) or stem cell transplantation (30), or who were at risk of bleeding due to hematologic malignancy or therapy-induced thrombocytopenia (20).
Phase of Care and Clinical Applications
PHASE OF CARE: Active antitumor treatment
Results
In the four studies reviewed, the administration of LA in premenstrual women with hematologic malignancy at risk of bleeding demonstrated efficacy in reducing episodes of uterine bleeding. The route of administration (IV, IM, or SQ) did not appear to have an effect upon efficacy. Efficacy was improved when LA was administered at least two weeks prior to the onset of thrombocytopenia.
Conclusions
Leuprolide acetate administration to premenopausal women at risk of uterine bleeding demonstrates efficacy in the prevention of uterine bleeding. In addition, there was no documentation of adverse effects from the hormone.
Limitations
The number of studies and participants included was small (4 and 94, respectively). In addition, there was not a randomization of participants.
Nursing Implications
Uterine bleeding in premenopausal females undergoing therapy for hematologic malignancy poses a significant risk. Administration of LA has the potential to mitigate this. There is a place for further research to define dose, administration, and timing of administration.