Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Post-Transplant Events

Ovarian recovery after stem cell transplantation

Abstract

Autologous or allogeneic SCT with conventional conditioning (chemotherapy with or without irradiation) has emerged as an effective and potentially curative therapy in patients with hematologic malignancies and in other selected solid tumors; however, several patients experience significant early and delayed side effects, including long-term endocrine imbalance and infertility. In spite of several reproductive recovery and pregnancy reports published in the oncology literature, review of medical literature reveals a paucity of comparable information in the SCT field. We report here four cases of ovarian recovery in patients who received hormonal replacement therapy after diagnosis of primary ovarian failure due to high-dose chemotherapy and SCT.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others

References

  1. Appelbaum FR, Herzig GP, Ziegler JL, Graw RG, Levine AS, Deisseroth AB . Successful engraftment of cryopreserved autologous bone marrow in patients with malignant lymphoma. Blood 1978; 52: 85–95.

    CAS  Google Scholar 

  2. Schimmer AD, Quatermain M, Imrie K, Ali V, McCrae J, Stewart K et al. Ovarian function after autologous bone marrow transplantation. J Clin Oncol 1998; 16: 2359–2363.

    Article  CAS  PubMed  Google Scholar 

  3. Gulati SC, Poznak CV . Pregnancy after bone marrow transplantation. J Clin Oncol 1998; 16: 1978–1985.

    Article  CAS  PubMed  Google Scholar 

  4. 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: 3045–3052.

    CAS  Google Scholar 

  5. Tauchmanova L, Selleri C, Rosa GD, Pagano L, Orio F, Lombardi G et al. High prevalence of endocrine dysfunction in long-term survivors after allogeneic bone marrow transplantation for hematologic diseases. Cancer 2002; 95: 1076–1084.

    Article  Google Scholar 

  6. Tauchmanova L, Selleri C, Rosa GD, Esposito M, Palomba S, Bifulco G et al. Gonadal status in reproductive age women after hematopoietic stem cell transplantation for hematological malignancies. Hum Reprod 2003; 18: 1410–1416.

    Article  PubMed  Google Scholar 

  7. Sklar C . Growth and endocrine disturbances after bone marrow transplantation in childhood. Acta Paediatr 1995; 411 (Suppl): 57–61.

    Article  CAS  Google Scholar 

  8. Brennan BMD, Shalet SM . Endocrine late effects after bone marrow transplant. Br J Haematol 2002; 118: 58–66.

    Article  Google Scholar 

  9. 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: 813–818.

    Article  CAS  Google Scholar 

  10. Piccioni P, Scirpa P, D'Emilio I, Sora F, Scarciglia M, Laurenti L et al. Hormonal replacement therapy after stem cell transplantation. Maturitas 2004; 49: 327–333.

    Article  CAS  PubMed  Google Scholar 

  11. Apperley JF, Reddy N . Mechanism and management of treatment-related gonadal failure in recipients of high dose chemo radiotherapy. Blood Rev 1995; 9: 93–116.

    Article  CAS  PubMed  Google Scholar 

  12. Beral V, Banks E, Reeves G . Evidence from randomised trials on the long-term effects of hormone replacement therapy. Lancet 2002; 360: 942.

    Article  PubMed  Google Scholar 

  13. Miller J, Chan BK, Nelson HD . Postmenopausal estrogen replacement and risk for venous thromboembolism: a systematic review and meta-analysis for the US Preventive Services Task Force. Ann Intern Med 2002; 136: 680–690.

    Article  CAS  PubMed  Google Scholar 

  14. Somers EC, Marder W, Christman GM, Ognevovski V, McCune WJ . Use of gonadotrophin-releasing hormone analog for protection against premature ovarian failure during cyclophosphamide therapy in women with severe lupus. Arthritis Rheum 2005; 52: 2761–2767.

    Article  CAS  PubMed  Google Scholar 

  15. Blumenfeld Z . Gynaecologic concerns for young women exposed to gonadotoxic chemotherapy. Curr Opin Obstet Gynecol 2003; 15: 359–370.

    Article  PubMed  Google Scholar 

  16. Peng C, Fan NC, Ligier M, Vaananen J, Leung PC . Expression and regulation of gonadotropin-releasing hormone (GnRH) and GnRH receptor messenger ribonucleic acids in human granulose luteal cells. Endocrinology 1994; 135: 1740–1746.

    Article  CAS  PubMed  Google Scholar 

  17. Blumenfeld Z, Avivi I, Linn S, Epelbaum R, Shahar BM, Haim N . Prevention of irreversible chemotherapy-induced ovarian damage in young women with lymphoma by a gonadotrophin-releasing hormone agonist in parallel to chemotherapy. Hum Reprod 1996; 11: 1620–1626.

    Article  CAS  PubMed  Google Scholar 

  18. Blumenfeld Z, Avivi I, Ritter M, Rowe MJ . Preservation of fertility and ovarian function and minimizing chemotherapy-induced gonadotoxicity in young women. J Soc Gynecol Investig 1999; 6: 229–239.

    Article  CAS  PubMed  Google Scholar 

  19. Recchia F, Sica G, De Filippis S, Saqqio G, Rosselli M, Rea S . Goserelin as ovarian protection in the adjuvant treatment of premenopausal breast cancer: a phase II pilot study. Anticancer Drugs 2002; 13: 417–424.

    Article  CAS  PubMed  Google Scholar 

  20. Franke HR, Smit WM, Vermes I . Gonadal protection by a gonadotropin-releasing hormone agonist depot in young women with Hodgkin's disease undergoing chemotherapy. Gynecol Endocrinol 2005; 20: 274–278.

    Article  CAS  PubMed  Google Scholar 

  21. 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: 271–277.

    Article  CAS  Google Scholar 

  22. Salooja N, Chatterjee R, McMillan AK, Kelsey SM, Newland AC, Milligan DW et al Successful pregnancies in women following single auto transplant for acute myeloid leukemia with a chemotherapy ablation protocol. Bone Marrow Transplant 1994; 13: 431–435.

    CAS  PubMed  Google Scholar 

  23. Jackson GH, Wood A, Taylor PR, Lennard AL, Lucraft H, Heppleston A et al. Early high-dose chemotherapy intensification with autologous bone marrow transplantation in lymphoma associated with retention of fertility and normal pregnancies in females. Scotland and Newcastle lymphoma group, UK. Leuk Lymphoma 1997; 28: 127–132.

    Article  CAS  PubMed  Google Scholar 

  24. Brice P, Haioun C, Andre M, Gisselbrecht C . Pregnancies after high-dose chemotherapy and autologous stem cell transplantation in aggressive lymphoma. Blood 2002; 100: 736.

    Article  CAS  PubMed  Google Scholar 

  25. Chatterjee R, Kottaridis PD . Treatment of gonadal damage in recipients of allogeneic or autologous transplantation for hematological malignancies. Bone Marrow Transplant 2002; 30: 629–635.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to E Carrier.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Liu, J., Malhotra, R., Voltarelli, J. et al. Ovarian recovery after stem cell transplantation. Bone Marrow Transplant 41, 275–278 (2008). https://doi.org/10.1038/sj.bmt.1705893

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.bmt.1705893

Keywords

This article is cited by

Search

Quick links