Successful achievement after heterotopic transplantations of long-term stored ovarian tissue in Hodgkin’s lymphoma survivor

Abstract

In this case report, we describe the outcomes of two heterotopic transplantations of cryopreserved ovarian tissue performed in a patient with HL, after 11 and 15 years of storage. At the age of 30, the patient underwent laparoscopy to collect ovarian tissue for cryopreservation before chemotherapy and radiotherapy. Eleven years later she experienced premature ovarian failure (POF). As the patient was only interested in endocrine function recovery, two heterotopic ovarian tissue transplantations were performed in the abdominal wall above the rectus muscle respectively 11 and 15 years after cryopreservation. Before transplantation, ovarian samples were analyzed to assess neoplastic contamination and tissue quality. The analysis on thawed ovarian tissue did not reveal micrometastasis and it showed well-preserved follicles and stroma. After both ovarian tissue grafting, menopausal symptoms ceased. The patient had periods approximately every 30-days and hormonal levels were within the premenopausal range. The endocrine function lasted 3-years after the first heterotopic transplantation and is still ongoing after second transplantation. Cryopreservation of ovarian tissue should be proposed to HL patients, as the incidence of POF as a long-term complication is not negligible. In these patients heterotopic transplantation is a useful tool to eliminate menopausal symptoms, preventing osteoporosis and reducing cardiovascular risks.

摘要

在本病例报告中, 我们描述了一例霍奇金淋巴瘤（HL）冻存卵巢组织两次异位移植的结果。患者30岁时, 行腹腔镜手术取得卵巢组织, 在化疗和放疗前进行冷冻保存。11年后, 她诊断为卵巢早衰（POF）。由于患者仅对恢复内分泌功能感兴趣, 在冷冻保存11年和15年后, 分别在腹直肌上方的腹壁进行了两次卵巢组织异位移植。移植前, 分析卵巢样本以评估肿瘤污染和组织质量。卵巢组织解冻后未见微小转移灶, 可见保存良好的卵泡和间质。两次卵巢组织移植后, 更年期症状均消失。患者大约每30天来一次月经, 激素水平维持在绝经前范围内。第一次异位移植后内分泌功能持续3年, 第二次移植后内分泌功能持续到现在。应建议HL患者行卵巢组织冷冻保存, 因为POF作为一种长期并发症的发生率是不可忽视的。在这些患者中, 异位移植是消除更年期症状、预防骨质疏松症和降低心血管风险的有效手段。

The Chinese abstracts are translated by Prof. Dr. Xiangyan Ruan and her team: Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China.

Keywords:

• Ovarian tissue cryopreservation
• fertility preservation
• heterotopic transplantation
• ovarian function recovery
• Hodgkin’s lymphoma

Acknowledgements

The authors thank the native speaker Danielle Calandrino for the English revision of the manuscript.

Disclosure statement

No potential conflict of interest was reported by the authors.