Successful Pregnancy and Delivery After Radiation With Ovarian Shielding for Acute Lymphocytic Leukemia Before Menarche.
Total body irradiation is performed as a preconditioning regimen to inhibit graft-versus-host disease after bone marrow transplantation and to eradicate remaining tumor cells. However, these regimens result in delayed secondary sex characteristics and failure of ovarian function recovery, leading to amenorrhea and infertility. Herein, we report a case of an 11-year-old girl diagnosed with acute lymphocytic leukemia who received induction chemotherapy and prophylactic cranial irradiation. For bone marrow transplantation, she received total body irradiation of 12 Gy with uterine and ovarian shielding at 13 years of age. The patient remained in remission and menarche began at 14 years of age. At 23, she became pregnant and delivered a baby naturally with no abnormalities.
Departments of *Radiology §Pediatrics and Child Health, Nihon University School of Medicine, Itabashi †Radiology Clinic, Saonoda Medical Corporations, Adachi, Tokyo ‡Department of Radiation Oncology, Kawasaki Saiwai Hospital, Kawasaki, Kanagawa, Japan.
Naoya
N
Ishibashi
Toshiya
T
Maebayashi
Takuya
T
Aizawa
Masakuni
M
Sakaguchi
Osamu
O
Abe
Tsutomu
T
Saito
Yoshiaki
Y
Tanaka
Motoaki
M
Chin
Hideo
H
Mugishima
D000293:Adolescent; D017668:Age of Onset; D016026:Bone Marrow Transplantation; D002648:Child; D005260:Female; D005298:Fertility / Q000528:radiation effects; D006801:Humans; D008572:Menarche; D010053:Ovary / Q000528:radiation effects*; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy / Q000532:radiotherapy* / Q000601:surgery; D011247:Pregnancy; D011482:Protective Devices; D011832:Radiation Injuries / Q000517:prevention & control*; D014916:Whole-Body Irradiation / Q000009:adverse effects*; D055815:Young Adult