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[Successful pregnancy after allogeneic bone marrow transplantation: two case reports]
N Hirabayashi1, S Goto, C Isogai
1Department of Hematology, Nagoya Daini Red Cross Hospital.
Summary
Successful pregnancies are possible after bone marrow transplantation (BMT) using high-dose chemotherapy and total lymphoid irradiation (TLI). These cases show that individuals can have children years after undergoing BMT for severe aplastic anemia and paroxysmal nocturnal hemoglobinuria.
Area of Science:
- Hematology
- Reproductive Medicine
- Oncology
Background:
- Allogeneic bone marrow transplantation (BMT) is a life-saving procedure for hematological disorders.
- Conditioning regimens often involve high-dose chemotherapy and radiation, raising concerns about long-term fertility.
- Severe aplastic anemia and paroxysmal nocturnal hemoglobinuria are serious conditions requiring intensive treatment.
Observation:
- A 15-year-old female with severe aplastic anemia underwent BMT with cyclophosphamide (CY) and total lymphoid irradiation (TLI).
- She successfully conceived and delivered a healthy child 92 months post-BMT.
- A 22-year-old male with paroxysmal nocturnal hemoglobinuria received BMT with CY and TLI, fathering a child 32 months later.
Findings:
- High-dose chemotherapy (200 mg/kg cyclophosphamide) and total lymphoid irradiation (4.5-7.5 Gy TLI) did not preclude successful pregnancies.
- These cases demonstrate the potential for normal reproductive capacity following intensive BMT conditioning.
- Fertility can be preserved or restored after BMT in young adults.
Implications:
- These findings offer hope for improved quality of life and reproductive options for BMT survivors.
- The data suggest that current BMT conditioning protocols may be compatible with future pregnancies.
- Further research into fertility preservation strategies post-BMT is warranted.