Effect of Methotrexate on Anti-Mullerian Hormone Levels, β-hCG and Tumor Size in Women with Low-Risk Gestational Trophoblast Disease

Tita Husnitawati Madjid, Imas Masitoh, Ali Budi Harsono, Benny Hasan Purwara, Andi Rinaldi, Johannes Cornelius Mose, Sunardi Sunardi


Abstract


Introduction: This study aimed to evaluate the effect of methotrexate (MTX) chemotherapy on anti-mullerian hormone (AMH) levels, human chorionic gonadotropin (HCG) levels, and tumor size in women with gestational trophoblastic disease (GTD).
Method: This study was conducted at Hasan Sadikin General Hospital, Bandung, West Java, from April to October 2020. The AMH level, beta human chorionic gonadotropin (ß-hCG) and tumor size in women with a low risk of GTD prior to and after MTX chemotherapy treatment were measured and compared.
Results: Our study found a reduction in mean AMH level to 0.82 ng/ml after the MTX chemotherapy. The mean AMH level after chemotherapy in women with low-risk GTD decreased to 0.82 ng / ml. In addition, ß-hCG level decreased after chemotherapy with MTX. There was a negative relationship between ß-hCG level and tumor size before and after chemotherapy. Higher ß-hCG levels and tumor size before chemotherapy resulted in a further increase in AMH after chemotherapy.
Discussion: There was a decrease in AMH and ß-hCG levels after three cycles of MTX chemotherapy in women with low-risk GTD. Tumor size and ß-hCG correlated with post-chemotherapy AMH results.

Pengaruh Metotreksat terhadap Kadar Hormon Anti Mullerian, β-hCG dan Ukuran Tumor pada Wanita dengan Penyakit Trofoblas Gestasional Risiko Rendah

Abstrak
Pendahuluan: Penelitian ini mengevaluasi efek kemoterapi metotreksat (MTX) terhadap kadar hormon anti-mullerian (AMH), kadar human chorionic gonadotropin (HCG), dan ukuran tumor pada wanita yang didiagnosis penyakit trofoblas gestasional (GTD) risiko rendah.
Metode: Penelitian ini dilakukan di Rumah Sakit Umum Pusat Hasan Sadikin, Bandung, Jawa Barat, dari bulan April hingga Oktober 2020. Kadar AMH, beta human chorionic gonadotropin (ß-hCG), dan ukuran tumor pada wanita dengan GTD risiko rendah sebelum dan sesudah pengobatan kemoterapi MTX diukur dan dibandingkan.
Hasil: Pada penelitian kami menemukan penurunan kadar AMH rata-rata menjadi 0,82 ng/ml setelah kemoterapi MTX. Rata-rata kadar AMH setelah kemoterapi pada wanita dengan GTD risiko rendah menurun menjadi 0,82 ng/ml. Selain itu, kadar ß-hCG juga menurun setelah kemoterapi dengan MTX. Terdapat hubungan negatif antara kadar ß-hCG dan ukuran tumor sebelum kemoterapi dan AMH setelah kemoterapi. Kadar ß-hCG yang lebih tinggi dan ukuran tumor sebelum kemoterapi menunjukkan peningkatan lebih tinggi pada AMH setelah kemoterapi.
Kesimpulan: Terjadi penurunan kadar AMH dan ß-hCG setelah tiga siklus kemoterapi MTX pada wanita dengan GTD risiko rendah. Ukuran tumor dan kadar ß-hCG berkorelasi dengan hasil kadar AMH setelah kemoterapi.

Kata kunci: Kemoterapi, Metotreksat, Hormon anti-mullerian, ß-hCG, Tumor trofoblas gestasional


Keywords


Chemotherapy, Methotrexate, Anti-mullerian hormone, ß-hCG, Tumor gestational trophoblast

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DOI: http://dx.doi.org/10.24198/obgynia.v7i1.610

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