Ovarian cryopreservation is a technique for fertility preservation of cancer patients. About 13 live births resulted from this technique since about 1995 when the experimental technique began after research in sheep.
This study involved the ovaries from 18 females with a mean age of 14.5 years for acute lymphoblastic leukemia (ALL) and 24.7 years for those with chronic myeloid leukemia (CML).
- Histology did not identify the cancer cells in any of the ovaries.
- Using a technique called real-time quantitative polymerase chain reaction (RT-qPCR), the scientists found cancerous cells in the ovarian tissue of 70% of the ALL patients and 33% of the CML patients.
- Further, they transplanted the human ovarian tissue into mice and 4/12 mice developed tumors from the ALL ovaries.
These data indicate that ovarian tissue cryopreservation is likely unsafe for patient with these cancers because they risk recurrence of the cancer is the ovarian tissue is transplanted into their bodies.
Reimplantation of cryopreserved ovarian tissue from patients with acute lymphoblastic leukemia is potentially unsafe.
Dolmans MM, Marinescu C, Saussoy P, Van Langendonckt A, Amorim C, Donnez J.
Department of Gynecology, GYNE Research Unit, Institut de Recherche Experimentale et Clinique, Universite Catholique de Louvain, Brussels, Belgium
Ovarian tissue cryopreservation is currently proposed to young cancer patients to preserve their fertility before radio-chemotherapy. The potential risk is that the tissue might harbor malignant cells that could induce disease recurrence. We therefore decided to evaluate the presence of leukemic cells in cryopreserved ovarian tissue from 18 leukemic patients: 6 with chronic myeloid leukemia (CML) and 12 with acute lymphoblastic leukemia (ALL). In each case, histology, RT-qPCR and long-term (6 months) xenografting to immunodeficient mice were used. Histology did not identify any malignant cells in the ovarian tissue. By RT-qPCR, 2 out of 6 CML patients were positive for BCR-ABL in their ovarian tissue. Among the 12 ALL patients, 7 of the 10 with available molecular markers showed positive leukemic markers in their ovarian tissue (translocations or rearrangement genes). Four mice grafted with ovarian tissue from ALL patients developed intraperitoneal leukemic masses. In conclusion, this study demonstrates, by RT-qPCR, ovarian contamination by malignant cells in acute as well as chronic leukemia, while histology fails to do so. Moreover, chemotherapy before ovarian cryopreservation does not exclude malignant contamination. Finally, reimplantation of cryopreserved ovarian tissue from ALL and CML patients puts them at risk of disease recurrence.