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Successful pregnancy and childbirth after reduced-intensity conditioning and partially HLA-mismatched BMT

Bone Marrow Transplantation volume 43, pages 969–970 (2009)Cite this article

Ovarian failure and permanent infertility occur in nearly all women of child-bearing age who are treated with myeloablative conditioning and allo-SCT.1, 2 Recently, highly immunosuppressive but reduced-intensity conditioning regimens have enabled the engraftment of allogeneic cells and their resulting graft-versus-tumor effects.3, 4, 5 However, the effect of reduced-intensity allo-SCT, or RIST, on the reproductive function of young women has not been examined. Here we report on two women who had successful pregnancies and childbirths after RIST for lymphoma.

Case 2: A 28-year-old woman was diagnosed at the age of 25 years with stage IIB nodular sclerosis Hodgkin's lymphoma with an associated 16 × 9 cm2 mediastinal mass. The disease was refractory to three distinct regimens of multi-agent chemotherapy, but the mediastinal mass responded partially to radiation therapy. At the age of 26 years she underwent partially HLA-mismatched RIST using the same regimen as in Case 1. Pre-conditioning serum levels of estradiol and follicle-stimulating hormone were 58 pg/ml and 6.2 IU/ml, respectively, consistent with normal ovarian function. Full engraftment of donor cells was documented at 6 months after transplantation, and GVHD did not occur. Whole-body positron emission tomography/computed tomography scan showed no evidence of lymphoma at 16 months after transplantation. At 2 years after transplantation, the patient delivered her second child, a healthy baby girl, after a term pregnancy.

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Acknowledgements

This work was supported by grant P01 CA15396 from the National Cancer Institute. EJF is a Clinical Research Scholar of the Leukemia and Lymphoma Society of America.

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Authors and Affiliations

  1. Division of Hematologic Malignancies, Sidney Kimmel Comprehensive Cancer Center (SKCCC) at Johns Hopkins, Baltimore, MD, USA

    E J Fuchs, L Luznik, J Bolaños-Meade, R A Brodsky, R F Ambinder & R J Jones

  2. St Agnes Cancer Center, Baltimore, MD, USA. E-mail: fuchsep@jhmi.edu,

    C B Miller

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  1. E J Fuchs
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Fuchs, E., Luznik, L., Bolaños-Meade, J. et al. Successful pregnancy and childbirth after reduced-intensity conditioning and partially HLA-mismatched BMT. Bone Marrow Transplant 43, 969–970 (2009). https://doi.org/10.1038/bmt.2008.416

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