Impact of reduced-intensity conditioning allogeneic stem cell transplantation on women's fertility

Clin Lymphoma Myeloma Leuk. 2013 Dec;13(6):704-10. doi: 10.1016/j.clml.2013.05.014. Epub 2013 Sep 24.

Abstract

Introduction: Available data on women fertility for younger patients treated using RIC Allo-SCT are still limited. We evaluated ovarian function and fertility among female patients younger than 35 years who received RIC Allo-SCT for hematological malignancy or aplastic anemia (AA).

Patients and methods: Information on therapies before RIC Allo-SCT were collected. Data on ovarian function and fertility evaluation after RIC Allo-SCT included clinical and biological criteria. Twenty-two patients were evaluated.

Results: After RIC Allo-SCT, amenorrhea affects 68.1% of patients. Ovarian function was impaired for 86.3% of cases. All 3 AA patients have regular cycles and became pregnant after RIC Allo-SCT. Only 6 (27.2%) patients declared to have been correctly informed before RIC Allo-SCT on potential deleterious effects on fertility of anticancer treatment and only 36.8% of patients with ovarian failure had a hormonal supplementation.

Conclusion: Results showed a high rate of ovarian failure, evaluated by clinical and biological criteria. The difference between AA and malignant diseases might suggest that a potential deleterious role was played by previous anticancer treatments rather than by RIC Allo-SCT.

Keywords: Allogeneic stem cell transplantation; Chemotherapy; Fertility preservation; Hormone replacement therapy; Premature ovarian failure.

MeSH terms

  • Adolescent
  • Adult
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Female
  • Fertility / drug effects*
  • Fertility / radiation effects*
  • Hematopoietic Stem Cell Transplantation / adverse effects*
  • Humans
  • Middle Aged
  • Ovary / drug effects
  • Ovary / radiation effects
  • Pregnancy
  • Primary Ovarian Insufficiency / etiology
  • Radiotherapy / adverse effects
  • Risk Factors
  • Transplantation Conditioning / adverse effects*
  • Transplantation Conditioning / methods
  • Transplantation, Homologous
  • Young Adult