Meirow, D., Rabinovici, J., Katz, D., Or, R., & Ben-Yehuda, D. (2006). Prevention of severe menorrhagia in oncology patients with treatment-induced thrombocytopenia by luteinizing hormone-releasing hormone agonist and depo-medroxyprogesterone acetate. Cancer, 107, 1634–1641.
Medical information was collected from a computer database. Patients received either DMPA or D- tryptophan -6-leutenizng hormone-releasing hormone agonist (GnRH-a) or no treatment before myelosuppressive chemotherapy.
Four patients were excluded because of gynecologic pathology. Average days of thrombocytopenia was 24.75 +/- 23.6 days. There was no statistical significant difference between groups regarding duration of thrombocytopenia. There was no difference in moderate to severe nonvaginal bleeding. There was no difference in platelet /packed red blood cells and fresh frozen plasma transfusions. Moderate/severe vaginal bleeding occurred in 16.8%—both treatment groups had lower rates of menorrhagia than untreated groups. None of the GnRH-a group had moderate/severe vaginal bleeding (p-0.002). There was a need for urgent gynecologic consult—untreated versus treated (P < 0.0001). Urgent treatment with estrogen was needed in the DMPA group but not the GnRh-a group (P = 0.004).