Successful pregnancy following busulfan and cyclophosphamide conditioning and allogeneic bone marrow transplantation for chronic myeloid leukemia.

摘要

Recovery of gonadal function in patients after allogeneic stem cell transplantation for hematologic malignancies is uncommon, and only a few cases have been reported. We report the case of a 39-year-old woman who had a normal full-term delivery 8 years after allogeneic bone marrow transplantation for chronic myeloid leukemia. Conditioning consisted of cyclophosphamide 120 mg/kg over 2 days and Busulfan 16 mg/kg over 4 days (BuCy). To our knowledge, this is the second reported case of pregnancy after BuCy conditioning.An increasing number of young women suffering from leukemia and other malignant and nonmalignant disorders are being cured by stem cell transplantation (SCT), raising the concern of late adverse effects of this procedure. These young people often wish to resume a high quality of life, and usually wish to have children. Most pretransplant conditioning protocols include alkylating agents, irradiation, or both, either of which can cause germinal epithelium depletion and infertility . In the nontransplant setting, the frequency of early menopause, azoospermia and germ cell destruction varies with the type and total dose of alkylating agent or irradiation, as well as patient sex and age at the time of treatment administration . Despite the gonadal toxicity of SCT, the literature documents successful pregnancies after therapy; however, the true incidence of pregnancy and pregnancy-related complications after transplantation are unknown [4-11].