Abstract
As the number of young long-term survivors of hematopoietic stem cell transplantation (HSCT) for acute leukemia continues to increase, post-transplant infertility is becoming a significant concern. HSCT, particularly with cyclophosphamide and total body irradiation conditioning, is known to cause secondary premature ovarian failure, resulting in infertility. To preserve post-transplant fertility, several methods have been proposed, including in vitro fertilization (IVF) with embryo cryopreservation. Due to the aggressiveness of acute leukemia, however, patients have little chance to undergo egg harvesting and IVF before they must begin receiving chemotherapy. To the best of our knowledge, there have been no detailed reports of successful pregnancy after HSCT using IVF with embryo cryopreservation and transfer in a patient with acute myeloid leukemia. Here, we report the case of a 42-year-old woman with acute myeloid leukemia who became pregnant 2 years and 2 months after allogeneic bone marrow transplantation via IVF-embryo transfer with an egg collected after induction therapy and delivered a full-term healthy infant.
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References
Sanders JE, Pritchard S, Mahoney P, Amos D, Buckner CD, Witherspoon RP, et al. Growth and development following marrow transplantation for leukemia. Blood. 1986;68:1129–35.
Sanders JE, Buckner CD, Amos D, Levy W, Appelbaum FR, Doney K, et al. Ovarian function following marrow transplantation for aplastic anemia or leukemia. J Clin Oncol. 1988;6:813–8.
Matias K, Matias C, Teixeira H, Freire AD, Azevedo A. Successful pregnancy following busulfan and cyclophosphamide conditioning and allogeneic bone marrow transplantation for chronic myeloid leukemia. Biol Blood Marrow Transpl. 2008;14:944–5.
Wu KN, Luo Y, Liu LZ, Zhao YM, Hu YX, Tan YM, et al. Twin pregnancy and childbirth after reduced-intensity conditioning allogeneic haematopoietic stem cell transplantation combined with imatinib mesylate for chronic myeloid leukemia: case report and literature review. J Int Med Res. 2012;40:2409–15.
Lipton JH, Virro M, Solow H. Successful pregnancy after allogeneic bone marrow transplant with embryos isolated before transplant. J Clin Oncol. 1997;15:3347–9.
Sanders JE, Hawley J, Levy W, Gooley T, Buckner CD, Deeg HJ, et al. Pregnancies following high-dose cyclophosphamide with or without high-dose busulfan or total-body irradiation and bone marrow transplantation. Blood. 1996;87:3045–52.
Salooja N, Szydlo RM, Socie G, Rio B, Chatterjee R, Ljungman P, et al. Pregnancy outcomes after peripheral blood or bone marrow transplantation: a retrospective survey. Lancet. 2001;358:271–6.
Filipovich AH, Weisdorf D, Pavletic S, Socie G, Wingard JR, Lee SJ, et al. National Institutes of Health consensus development project on criteria for clinical trials in chronic graft-versus-host disease: I. Diagnosis and staging working group report. Biol Blood Marrow Transpl. 2005;11:945–55.
Borgmann-Staudt A, Rendtorff R, Reinmuth S, Hohmann C, Keil T, Schuster FR, et al. Fertility after allogeneic haematopoietic stem cell transplantation in childhood and adolescence. Bone Marrow Transpl. 2012;47:271–6.
Kanda Y, Wada H, Yamasaki R, Kawamura K, Ishihara Y, Sakamoto K, et al. Protection of ovarian function by two distinct methods of ovarian shielding for young female patients who receive total body irradiation. Ann Hematol. 2014;93:287–92.
Loren AW, Mangu PB, Beck LN, Brennan L, Magdalinski AJ, Partridge AH, et al. Fertility preservation for patients with cancer: American Society of Clinical Practice Guideline Update. J Clin Oncol. 2013;31:2500–10.
Jadoul P. Kim SS, ISFP Practice Committee. Fertility considerations in young women with hematological malignancies. J Assist Reprod Genet. 2012;29:479–87.
Joshi S, Savani BN, Chow EJ, Gilleece MH, Halter J, Jacobsohn DA, et al. Clinical guide to fertility preservation in hematopoietic cell transplant recipients. Bone Marrow Transpl. 2014;49:477–84.
Courbiere B, Prebet T, Mozziconacci MJ, Metzler-Guillemain C, Saias-Magnan J, Gamerre M. Tumor cell contamination in ovarian tissue cryopreserved before gonadotoxic treatment: should we systematically exclude ovarian autograft in a cancer survivor? Bone Marrow Transpl. 2010;45:1247–8.
National Comprehensive Cancer Network. NCCN Guidelines Version 1.2015. Adolescent and Young Adult Oncology. Fertility/Endocrine considerations. Available from: http://www.nccn.org/professionals/physician_gls/pdf/aya.pdf
Royal College of Physicians. The Royal College of Radiologists, Royal College of Obstetricians and Gynecologists. The effects of cancer treatment on reproductive functions; Guidance on management. Report of a Working Party. RCP: London, 2007. Available from: http://www.rcog.org.uk/womens-health/clinical-guidance/effects-cancer-treatment-reproductive-function-guidance-management
Meirow D, Epstein M, Lewis H, Nugent D, Gosden RG. Administration of cyclophosphamide at different stages of follicular maturation in mice: effects on reproductive performance and fetal malformations. Hum Reprod. 2001;16:632–7.
Meirow D, Schiff E. Appraisal of chemotherapy effects on reproductive outcome according to animal studies and clinical data. J Natl Cancer Inst Monogr. 2005;34:21–5.
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Nakajima, Y., Kuwabara, H., Kishimoto, K. et al. Successful pregnancy and delivery via in vitro fertilization with cryopreserved and thawed embryo transfer in an acute myeloid leukemia patient after allogeneic bone marrow transplantation. Int J Hematol 101, 417–420 (2015). https://doi.org/10.1007/s12185-014-1709-5
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DOI: https://doi.org/10.1007/s12185-014-1709-5