title: Protection of ovarian function by two distinct methods of ovarian shielding for young female patients who receive total body irradiation.
abstract: To prevent ovarian dysfunction due to total body irradiation, we started ovarian shielding at our center (Saitama Medical Center, Jichi Medical University (SMC-JMU)) with a long source axis distance, which is different from the original method used at the University of Tokyo Hospital (UTH). We retrospectively analyzed the outcome of eight patients with a median age of 20.5 years from SMC-JMU and compared the results with the published data for eight patients with a median age of 22 years from UTH. The recovery of ovarian function was observed in five and six patients, respectively. The cumulative incidence of ovarian recovery, while treating relapse and death without ovarian recovery as competing risks, was 68.8 % at 2 years after transplantation in the total population, and there was no statistically significant difference between the two institutions (p = 0.85). Age and the history of previous chemotherapy did not affect the incidence of ovarian recovery. Two patients from each center had a relapse of leukemia. Overall, among the 11 patients who have survived without relapse, only one has not achieved ovarian recovery. In conclusion, ovarian shielding with both methods strongly protected ovarian function. However, we should continue to monitor the relapse rate among patients who undergo this procedure.
authors.affiliation: Division of Hematology, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma Omiya-ku, Saitama, Saitama, 330-8503, Japan, ycanda-tky@umin.ac.jp.
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Kanda
authors.forename: Hidenori
authors.initials: H
authors.lastname: Wada
authors.forename: Ryoko
authors.initials: R
authors.lastname: Yamasaki
authors.forename: Koji
authors.initials: K
authors.lastname: Kawamura
authors.forename: Yuko
authors.initials: Y
authors.lastname: Ishihara
authors.forename: Kana
authors.initials: K
authors.lastname: Sakamoto
authors.forename: Masahiro
authors.initials: M
authors.lastname: Ashizawa
authors.forename: Miki
authors.initials: M
authors.lastname: Sato
authors.forename: Tomohito
authors.initials: T
authors.lastname: Machishima
authors.forename: Kiriko
authors.initials: K
authors.lastname: Terasako-Saito
authors.forename: Shun-Ichi
authors.initials: S
authors.lastname: Kimura
authors.forename: Hideki
authors.initials: H
authors.lastname: Nakasone
authors.forename: Misato
authors.initials: M
authors.lastname: Kikuchi
authors.forename: Rie
authors.initials: R
authors.lastname: Yamazaki
authors.forename: Junya
authors.initials: J
authors.lastname: Kanda
authors.forename: Shinichi
authors.initials: S
authors.lastname: Kako
authors.forename: Junji
authors.initials: J
authors.lastname: Nishida
authors.forename: Hidekazu
authors.initials: H
authors.lastname: Tsunoda
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Omori
authors.forename: Masanori
authors.initials: M
authors.lastname: Nakazawa
authors.forename: Osamu
authors.initials: O
authors.lastname: Tanaka
mesh_terms: D000293:Adolescent; D000328:Adult; D064591:Allografts; D005260:Female; D019337:Hematologic Neoplasms / Q000628:therapy; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D015994:Incidence; D008297:Male; D010049:Ovarian Diseases / Q000503:physiopathology / Q000517:prevention & control; D010053:Ovary / Q000502:physiology*; D011832:Radiation Injuries / Q000503:physiopathology / Q000517:prevention & control; D019172:Transplantation Conditioning / Q000009:adverse effects / Q000379:methods; D014916:Whole-Body Irradiation / Q000009:adverse effects / Q000379:methods; D055815:Young Adult