Ovarian tissue cryopreservation can be used to preserve fertility in women with certain types of lymphoma or tumors that are solid. While 13 live births have resulted from cryopreservation, women with leukemia may not be.
Cryopreservation involves taking an ovarian tissue sample and freezing the sample while women are undergoing aggressive chemotherapy and radiation. After recovery, the tissue can be implanted into the patient to restore fertility. For female patients with leukemia, the ovarian tissues could reintroduce cancer cells into the body causing a relapse of leukemia symptoms.
The two forms of leukemia in the hot seat are ALL and CML. ALL, or acute lymphoblastic leukemia. CML is chronic myelogenous leukemia. ALL is a fast moving cancer that affects white blood cells. CML moves slower and affects bone marrow. Patients with ALL and CML are most often younger than 35 years old with some patients diagnosed as young as 2. While these cases cause concern in regards to protecting fertility, cancer cells may live in cryopreserved cells even if they are not noticeable to the naked eye.
Researched used real-time quantitative polymerase chain reaction (RT-qPCR) to detect cancer cells in ovarian tissue samples. In 70% of the samples, cancer cells were detected with this test even though microscopic examination did not reveal the presence of cancer cells. ALL cancer cells are of particular concern. When ovarian tissue from ALL patients was implanted on mice, tumors grew within six months in four cases.
Alternative fertility preservation techniques may need to be developed for leukemia patients.
Source: M.M. Dolmans, C. Marinescu, P. Saussoy, A. Van Langendonckt, C. Amorim, J. Donnez. Blood. 16 August 2010.
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