Pregnancy after allogeneic hematopoietic stem cell transplantation in a Fanconi anemia patient

Atashkhoei, Simin; Fakhari, Solmaz; Bilehjani, Eissa; Farzin, Haleh

doi:10.2147/imcrj.s124414

Cited by 2 publications

(1 citation statement)

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“…Prior studies have analyzed fertility and pregnancy outcomes in transplanted patients with FA but focused only on adolescent or adult female patients, excluding a large proportion of this population. 12,[15][16][17] In addition, available data include only very small number of male patients with FA, 3,18 or only a focus on patients with a primary malignancy diagnosis and include little semen data. 19,20 We initially anticipated that HSCT overall would contribute to a higher incidence of POI and testicular failure because chemotherapy and radiation administered prior to HSCT are known to lead to gonadal failure.…”

Section: Discussionmentioning

confidence: 99%

Gonadal function in pediatric Fanconi anemia patients treated with hematopoietic stem cell transplant

et al. 2023

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Gonadal dysfunction and reduced fertility are clinical manifestations well described in patients with Fanconi anemia (FA) and following hematopoietic stem cell transplantation (HSCT). It is difficult to differentiate gonadal dysfunction from the primary disease itself or from HSCT procedures. Therefore, it is important to manage expectations about gonadal failure and infertility for all patients with FA, regardless of HSCT status. We performed a retrospective analysis of 98 pediatric patients with FA who were transplanted between July 1990 to June 2020 to evaluate the incidence of gonadal dysfunction in female and male patients with FA. New onset premature ovarian insufficiency (POI) was diagnosed in a total of 30 (52.6%) patients. Follicle-stimulating hormone (FSH) and luteinizing hormone (LH) levels were increased in patients diagnosed with POI. Anti-Mullerian Hormone (AMH) levels declined in POI patients after HSCT (r2 = 0.21, p = 0.001). Twenty (48.8%) male patients were diagnosed with testicular failure. FSH levels increased after HSCT even in patients without testicular failure (r2=0.17, p=0.005). Inhibin B levels decreased over time after HSCT in patients with testicular failure (r2 = 0.14, p = 0.001). These data indicate brisk decline in already impaired gonadal function in transplanted children with FA.

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