Eliminating malignant cells from cryopreserved ovarian tissue is possible in leukaemia patients.
Michelle SoaresPascale SaussoyMathilde MaskensHélène ReulChristiani A AmorimJacques DonnezMarie-Madeleine DolmansPublished in: British journal of haematology (2017)
Reimplantation of cryopreserved ovarian tissue (OT) can successfully restore ovarian function in young cancer patients after gonadotoxic treatment. However, for patients with leukaemia, there is a risk of malignant cell transmission. Our objective was to evaluate minimal disseminated disease in OT from leukaemia patients and test a follicle isolation technique to obtain disease-free follicle suspensions. Cryopreserved OT from 12 leukaemia patients was thawed and analysed by histology and long-term xenografting in immunosuppressed mice. In 10 patients, follicles were isolated from OT, and polymerase chain reaction (PCR) was performed on tissue, digested ovarian suspensions and isolated follicle suspensions to investigate leukaemic cell presence. Mean patient age was 17·1 years. An average of 3·2 follicles were isolated per mm² of cortex. Xenografting of OT induced leukaemic masses in 2/12 mice. PCR identified leukaemic cell presence in 66% of OT. Malignant cells were also detected in digested ovarian suspensions. However, none of the follicle samples (>2300 follicles tested) showed any malignant cell presence after washing. This study demonstrates that it is possible to recover large numbers of viable follicles from cryopreserved OT of leukaemia patients. All isolated and washed follicle suspensions tested negative for leukaemic cells, giving leukaemia patients genuine hope of fertility restoration.
Keyphrases
- young adults
- end stage renal disease
- ejection fraction
- chronic kidney disease
- newly diagnosed
- peritoneal dialysis
- prognostic factors
- stem cells
- magnetic resonance imaging
- type diabetes
- patient reported
- skeletal muscle
- insulin resistance
- pregnant women
- endothelial cells
- cell proliferation
- risk assessment
- umbilical cord