Preservation of ovarian function by ovarian shielding when undergoing total body irradiation for hematopoietic stem cell transplantation: A report of two successful cases

K. Nakagawa, Y. Kanda, H. Yamashita, Y. Hosoi, K. Oshima, K. Ohtomo, N. Ban, S. Yamakawa, S. Nakagawa, S. Chiba

Research output: Contribution to journalArticlepeer-review

25 Citations (Scopus)

Abstract

The purpose of this study was to evaluate the possibility of preserving ovarian function by ovarian shielding to reduce the irradiation dose in total body irradiation (TBI). The subjects in the study were females aged less than 40 years, who were undergoing allogeneic hematopoietic stem cell transplantation using a TBI-based regimen and who desired to have children after transplantation. For ovarian shielding, abdominal computed tomography (CT) and skin marking were performed in both the supine and prone positions, prior to the TBI. A pair of columnar blocks was placed just above the patient's body. Thus far three patients have been treated. The serum estradiol level decreased to an undetectable level (<8.5 pg/ml) after transplantation and the follicle-stimulating hormone (FSH) level increased above 90mIU/ml in all patients and they became amenorrheic. However, regular menstruation recovered in patients no. 1 and 2 about 800 and 370 days after transplantation, respectively, with a decrease in the serum FSH level. Menstruation did not recover in patient no. 3, and serum estradiol was transiently detected above 20 pg/ml. The preservation of ovarian function was made possible by ovarian shielding. However, a longer follow-up is needed to know if normal pregnancy and delivery can occur.

Original languageEnglish
Pages (from-to)583-587
Number of pages5
JournalBone Marrow Transplantation
Volume37
Issue number6
DOIs
Publication statusPublished - 2006 Mar

Keywords

  • Ovarian function
  • Ovarian shielding
  • Stem cell transplantation
  • Total body irradiation

ASJC Scopus subject areas

  • Hematology
  • Transplantation

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