Morphological study of the ovaries of leukaemic children

Himelstein-Braw, Ruth; Peters, Hannah; Faber, Mogens

doi:10.1038/bjc.1978.166

Cited by 145 publications

(53 citation statements)

References 14 publications

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“…The adverse effects of the treatment of malignant disease on reproductive function have long been recognised (Himelstein-Braw et al 1978, Chapman et al 1979. In women, both chemotherapy and radiotherapy result in loss of ovarian function due to follicular depletion, and radiotherapy to a field that includes the pelvis can have an adverse effect on the uterus (Howell & Shalet 1998, Meirow & Nugent 2001, Critchley & Wallace 2005.…”

Section: Introductionmentioning

confidence: 99%

Ovarian cryopreservation for fertility preservation: indications and outcomes

Anderson¹,

Wallace²,

Baird³

2008

Reproduction

121

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Female fertility preservation provides significantly different challenges to that for the male, with the only established method being cryopreservation of embryos thus necessitating the involvement of a male. Other, experimental, options include oocyte or ovarian tissue cryopreservation. The latter has been regarded as a potential method for more than a decade, but has resulted in the birth of only five babies. It is not possible to be certain how many women have had ovarian tissue cryopreserved. Oocyte cryopreservation also remains experimental, but w100-fold more babies have been born through this technique over the last two decades. Ovarian tissue cryopreservation has the potential advantages of preservation of a large number of oocytes within primordial follicles, it does not require hormonal stimulation when time is short and indeed may be appropriate for the pre-pubertal. Disadvantages include the need for an invasive procedure, and the uncertain risk of ovarian contamination in haematological and other malignancies. We here review this approach in the context of our own experience of 36 women, highlighting issues of patient selection especially in the young, and uncertainties over the effects of cancer treatments on subsequent fertility. Of these 36 women, 11 have died but 5 have had spontaneous pregnancies. So far, none have requested reimplantation of their stored ovarian tissue. Ovarian cryopreservation appears to be a potentially valuable method for fertility preservation, but the indications and approaches best used remain unclear.Reproduction (2008) 136 681-689

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Section: Introductionmentioning

confidence: 99%

Ovarian cryopreservation for fertility preservation: indications and outcomes

Anderson¹,

Wallace²,

Baird³

2008

Reproduction

121

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“…1,2 Ovarian failure rate is influenced by the patients' age at the time of chemotherapy, by the type of the primary disease and by the chemotherapy regimen given. 3 Since many of the patients are young women during their reproductive years, hormone replacement therapy (HRT) is usually recommended.…”

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confidence: 99%

Vaginal outflow tract obstruction by graft-versus-host reaction

Yanai

Shufaro

et al. 1999

Bone Marrow Transplant

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Summary:We describe a 25-year-old patient suffering from vaginal outflow obstruction which presented as secondary amenorrhea during hormone replacement therapy. The patient had undergone bone marrow transplantation for acute myelocytic leukemia, which caused ovarian failure. Oral mucositis associated with a chronic GVH reaction also occurred. For 3 years she was treated with HRT and had regular menses which gradually ceased and were associated with dyspareunia and abdominal cramps. Abdominal US examination demonstrated hematocolpus. Sonography guided adhesiolysis of a dense vaginal obstruction allowed free drainage with histologic confirmation of a graft-versus-host reaction. The possibility of vaginal stricture or obstruction should be considered in all patients after BMT who suffer from graft-versus-host disease. Keywords: graft-versus-host disease; gynecological complications; vaginal obstruction Secondary amenorrhea occurs in the majority of patients treated with high-dose radiochemotherapy followed by bone marrow transplantation (BMT), as a result of ovarian failure. 1,2 Ovarian failure rate is influenced by the patients' age at the time of chemotherapy, by the type of the primary disease and by the chemotherapy regimen given. 3 Since many of the patients are young women during their reproductive years, hormone replacement therapy (HRT) is usually recommended. 4 Menstruation induced by HRT shows that chemotherapy or BMT does not affect the endometrium.We describe a case of secondary amenorrhea in a young woman who suffered from chronic GVH after BMT. For 3 years she had HRT-induced menstruation that gradually ceased combined with the appearance of dyspareunia and period cramps. Case reportA 25-year-old female patient presented with secondary amenorrhea of 6 months duration, dyspareunia and abdomi-

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“…La fertilit6 apr~s traitement combinant vincristine, anthracyclines, 6-mercaptopurine, m6thotrexate et corticoides est habituellement conserv6e [11]. L'utilisation d'agents alkylants ou de cytosine arabinoside ~ plus de i g/m 2 est responsable de toxicit6 gonadique dans les deux sexes dont le retentissement est difficile ~ chiffrer pr6cis6ment en raison de la grande variation protocoles sch6mas th6ra-peutiques actuels et du manque de recul pour 6valuer la toxicit6 gonadique chez des patients p6diatriques [ 11].…”

Section: Atteinte De La Fertilite Selon Lies Pathologiesunclassified

“…Une ~tude portant sur 94 enfants issus de femmes trait4es pour choriocarcinome placentaire retrouve une incidence des anomalies chromosomiques cong4ni-tales de 0,7% contre 1,6% dans la population t4moin et aucun retard mental avec un recul maximal de 25 ans [23]. Une seule publication portant sur 202 grossesses, chez 100 patients ant4rieurement trait4s par chimioth4rapie, a rapport~ deux anomalies cardiaques apr~s actinomycine D (une t4tralogie de Fallot et une anomalie du septum ventriculaire) [11]. N~anmoins cette observation n'a pas ~t4 confirm4e.…”

Section: Pronostic De La Grossesseunclassified

Effet de la chimiothérapie sur la fonction testiculaire et ovarienne

Linassier

Colombat

1996

Androl.

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RESUMELes progr~s en canc~rologie permettent des gu~risons fr~quentes chez renfant et radulte jeune. L'oligo azoospermie et les troubles fonctionnels du spermatozoide chez rhomme, l'am~-norrh~e et la m~nopause pr~coce chez la femme sont frequents et preserver la fertilit~ des patients doit ~tre un soucis du th~rapeute. Les alkylants sont fortement gonadotoxiques suivant une relation de dose-d~pendance. D'autres drogues comme le cisplatine, les anthracyclines, les vincaalcaloides et les ~pipodophyllotoxines sont mod~-r~ment gonadotoxiques tandis que les antim~tabolites ont une toxicit~ gonadique mineure. La fertilit~ est plus alt~r~e chez l'homme que chez la femme et diminue d'autant plus chez la femme qu'elle est proche de la mdnopause. L'ovaire pr~pubertaire est moins sensible aux effets des chimiotherapies mais n'est pas totalement protege. Aucune t~ratog~nicit~ n'a pu ~tre formellement attribute ~ la chimioth~rapie. N~anmoins une grossesse pendant une exposition ~ des agents cytotoxiques est fortement d~con-seill~e et un d~lai de deux ans semble pouvoir ~tre recommand~ avant une conception.

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Morphological study of the ovaries of leukaemic children

Cited by 145 publications

References 14 publications

Ovarian cryopreservation for fertility preservation: indications and outcomes

Ovarian cryopreservation for fertility preservation: indications and outcomes

Vaginal outflow tract obstruction by graft-versus-host reaction

Effet de la chimiothérapie sur la fonction testiculaire et ovarienne

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