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Risks and benefits of ovarian shielding in female patients undergoing TBI: a decision analysis

Bone Marrow Transplantation volume 46, pages 1145–1147 (2011)Cite this article

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In a recent issue of Bone Marrow Transplantation, Courbiere et al.1 raised the possibility of leukemia relapse after autologous transplantation of cryopreserved ovarian tissue from leukemic cell contamination in the graft. They detected a small copy number of Bcr–Abl transcripts by RQ-PCR in the ovarian tissue from an 18-year-old woman with CML. We agree that ovarian transplantation could be proposed (once patients are informed of the risk of leukemia relapse), as there were few contaminating leukemic cells and a GVL effect may be protective.

In Japan, cryopreservation of ovarian tissue is not available, but two other strategies are used to preserve fertility in young women undergoing hematopoietic SCT. One is embryo or oocyte cryopreservation for women with or without a partner, respectively. Although the success rate after transfer of thawed fertilized oocytes had been low previously, both post-thaw survival and fertilization rates of frozen oocytes2, 3 have improved. Nonetheless, concern remains regarding the potential for chromosomal aneuploidy or other karyotypic abnormalities in the offspring, as cryopreservation may affect the meiotic spindle of oocytes.4 In addition, it is generally difficult to obtain good-quality oocytes from patients receiving chemotherapy.5

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References

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  1. Division of Hematology, Saitama Medical Center, Jichi Medical University, Saitama, Japan. E-mail: ycanda-tky@umin.ac.jp,

    Y Kanda, K Sakamoto, M Ashizawa, M Sato, K Terasako, M Kikuchi, S-I Kimura, S Okuda, S Kako & K Oshima

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  1. Y Kanda
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  2. K Sakamoto
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Kanda, Y., Sakamoto, K., Ashizawa, M. et al. Risks and benefits of ovarian shielding in female patients undergoing TBI: a decision analysis. Bone Marrow Transplant 46, 1145–1147 (2011). https://doi.org/10.1038/bmt.2010.240

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