[Artificial insemination using the husband's frozen sperm in a patient with chronic myelogenous leukemia after bone marrow transplantation].
A 37-year-old man with chronic myelogenous leukemia (CML) was scheduled to receive a bone marrow allograft from an HLA-matching sibling. He was married without children, and desired to have a child in the future. Sperm was collected before transplantation and frozen for preservation. Induction therapy performed using 8 mg/kg of busulfan, 120 mg/kg of cyclophosphamide, splenic irradiation (4.5Gy), and total body irradiation (10Gy), and then allogenic bone marrow transplantation (BMT) was carried out. His post-transplantation course was uneventful and cyclosporin therapy was finished on day 187. The Philadelphia chromosome disappeared on day 20 after BMT and PCR analysis was negative for the bcr/abl rearrangement, suggesting the possibility of cure. Accordingly, artificial insemination was attempted using the frozen sperm. His wife became pregnant after the 4th attempt and a healthy baby was delivered. Transplantation recipients often become sterile because they receive ultra-high doses of chemotherapy and irradiation. However, it is still possible to have children if sperm or ova are preserved prior to transplantation. This is thought to improve the quality of life after BMT.
Watanabe
H
H
Third Department of Internal Medicine, Jikei University School of Medicine.
Asai
O
O
Tada
N
N
Yano
S
S
Katoh
A
A
Uno
S
S
Ohsawa
H
H
Unozawa
T
T
Fujii
T
T
Nakamura
T
T
D000328:Adult; D016026:Bone Marrow Transplantation; D005260:Female; D005615:Freezing; D006801:Humans; D007315:Insemination, Artificial; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000628:therapy*; D008297:Male; D011247:Pregnancy; D012662:Semen Preservation / Q000379:methods*; D014184:Transplantation, Homologous