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Transplant Toxicities

Fertility preservation issues in pediatric hematopoietic stem cell transplantation: practical approaches from the consensus of the Pediatric Diseases Working Party of the EBMT and the International BFM Study Group

Bone Marrow Transplantation volume 52, pages 1406–1415 (2017)Cite this article

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Abstract

Fertility preservation is an urgent challenge in the transplant setting. A panel of transplanters and fertility specialists within the Pediatric Diseases Working Party of the European Society for Blood and Marrow Transplantation (EBMT) and the International BFM Study Group provides specific guidelines. Patients and families should be informed of possible gender- and age-specific cryopreservation strategies that should be tailored according to the underlying disease, clinical condition and previous exposure to chemotherapy. Semen collection should be routinely offered to all postpubertal boys at the diagnosis of any disease requiring therapy that could potentially impair fertility. Testicular tissue collection might be offered to postpubertal boys; nevertheless, its use has been unsuccessful to date. Oocyte collection after hormonal hyperstimulation should be offered to postpubertal girls facing gonadotoxic therapies that could be delayed for the 2 weeks required for the procedure. Ovarian tissue collection could be offered to pre-/post-pubertal girls. Pregnancies have been reported after postpubertal ovarian tissue reimplantation; however, to date, no pregnancy has been reported after the reimplantation of prepubertal ovarian tissue or in vitro maturation of pre-/post-pubertal ovarian tissue. Possible future advances in reproductive medicine could change this scenario. Health authorities should prioritize fertility preservation projects in pediatric transplantation to improve patient care and quality of life.

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Acknowledgements

We thank Francesca Fossati and Andreina di Palma for secretarial support.

Author information

Authors and Affiliations

  1. Clinica Pediatrica, Università degli Studi di Milano Bicocca, Fondazione Monza e Brianza per il Bambino e la sua Mamma, Ospedale San Gerardo, Monza, Italy

    A Balduzzi

  2. Hemato-Immunology Department, Robert-Debre Hospital, APHP and Paris-Diderot University, Paris, France

    J-H Dalle

  3. Division of Hematology-Oncology and Stem Cell Transplantation, Children’s Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland

    K Jahnukainen & K Vettenranta

  4. Division of Reproductive Medicine and Endocrinology, Department of Obstetrics and Gynecology, Inselspital Bern, University Hospital, Bern, Switzerland

    M von Wolff

  5. Bone Marrow Transplant Department, Great Ormond Street Hospital, London, UK

    G Lucchini

  6. Department of Pediatric and Adolescent Medicine, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark

    M Ifversen

  7. The Fertility Clinic, Copenhagen University Hospital, Copenhagen, Denmark

    K T Macklon

  8. Adolescent and Young Adult Hematology Unit, Saint Louis Hospital, Assistance Publique-Hôpitaux de Paris, University Pierre et Marie Curie, Paris, France

    C Poirot

  9. Department of Pediatric Hematology/Oncology, University Children’s Hospital of Basel, Basel, Switzerland

    T Diesch

  10. Division for Stem Cell Transplantation and Immunology, Department for Children and Adolescents, University Hospital, Goethe University Frankfurt am Main, Frankfurt, Germany

    A Jarisch, A M Willasch, T Klingebiel & P Bader

  11. Willem-Alexander Children’s Hospital, Leiden University Medical Center, Leiden, The Netherlands

    D Bresters & A Lankester

  12. Pediatric Hematology Oncology, Schneider Children's Medical Center of Israel, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

    I Yaniv

  13. Department of Paediatric Haematology, Royal Hospital for Children, Scotland, UK

    B Gibson

  14. Centro di Medicina della Riproduzione Biogenesi, Istituti Clinici Zucchi, Monza, Italy

    R Fadini

  15. Department of Gynecology and Obstetrics, Ospedale San Gerardo di Monza, Monza, Italy

    L Ferrari

  16. St Anna Children's Hospital, UKKJ, MUW, Vienna, Austria

    A Lawitschka & C Peters

  17. Division of Reproductive Medicine and Endocrinology, Department of Obstetrics and Gynaecology, University Hospital, Basel, Switzerland

    A Ahler & R Moffat

  18. Division of Reproductive Medicine, Department of Obstetrics and Gynecology, Endocrinology and Infertility, University Hospital, JW Goethe University, Frankfurt, Germany

    N Sänger

  19. Department of Pediatric Hematology, Oncology and Stem Cell Transplantation, University Hospital, University of Regensburg, Regensburg, Germany

    S Corbacioglu

  20. Department of Pediatrics, Hémato-Oncologie Pédiatrique, CANSEARCH Research Laboratory, Université de Médecine de Genève, Geneva, Switzerland

    M Ansari

  21. EBMT Paris Office, Hospital Saint Antoine, Paris, France

    A Dalissier & E Beohou

  22. Department of Pediatric Hematology and Oncology, University Hospital Motol, Prague, Czech Republic

    P Sedlacek

  23. Pediatric Oncology and Hematology Department, Hospital Universitario Vall d’Hebron, Barcelona, Spain

    C D De Heredia Rubio

  24. Department of Pediatric Oncology, Hematology and Transplantology, University of Medical Sciences, Poznan, Poland

    J Wachowiak

  25. Department of Pediatrics, Bahcesehir University School of Medicine, Pediatric Stem Cell Transplantation Unit, Istanbul, Turkey

    A Yesilipek

  26. Paediatric Oncology Unit, Paediatric Transplant Unit, Polytechnic and University Hospital ‘LA FE’, Valencia, Spain

    E Trigoso

Authors
  1. A Balduzzi
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  2. J-H Dalle
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  3. K Jahnukainen
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  4. M von Wolff
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  5. G Lucchini
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  6. M Ifversen
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  7. K T Macklon
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  8. C Poirot
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  9. T Diesch
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  10. A Jarisch
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  11. D Bresters
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  12. I Yaniv
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  13. B Gibson
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  14. A M Willasch
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  15. R Fadini
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  16. L Ferrari
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  17. A Lawitschka
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  18. A Ahler
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  19. N Sänger
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  20. S Corbacioglu
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  21. M Ansari
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  22. R Moffat
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  23. A Dalissier
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  24. E Beohou
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  25. P Sedlacek
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  26. A Lankester
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  27. C D De Heredia Rubio
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  28. K Vettenranta
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  29. J Wachowiak
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  30. A Yesilipek
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  31. E Trigoso
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  32. T Klingebiel
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  33. C Peters
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  34. P Bader
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Consortia

on behalf of the Pediatric Diseases Working Party of the European Society for Blood and Marrow Transplantation and the International BFM Study Group

Corresponding authors

Correspondence to A Balduzzi or P Bader.

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The authors declare no conflict of interest.

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Balduzzi, A., Dalle, JH., Jahnukainen, K. et al. Fertility preservation issues in pediatric hematopoietic stem cell transplantation: practical approaches from the consensus of the Pediatric Diseases Working Party of the EBMT and the International BFM Study Group. Bone Marrow Transplant 52, 1406–1415 (2017). https://doi.org/10.1038/bmt.2017.147

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  • DOI: https://doi.org/10.1038/bmt.2017.147

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