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Annals of Hematology

, Volume 93, Issue 2, pp 287–292 | Cite as

Protection of ovarian function by two distinct methods of ovarian shielding for young female patients who receive total body irradiation

  • Yoshinobu Kanda
  • Hidenori Wada
  • Ryoko Yamasaki
  • Koji Kawamura
  • Yuko Ishihara
  • Kana Sakamoto
  • Masahiro Ashizawa
  • Miki Sato
  • Tomohito Machishima
  • Kiriko Terasako-Saito
  • Shun-ichi Kimura
  • Hideki Nakasone
  • Misato Kikuchi
  • Rie Yamazaki
  • Junya Kanda
  • Shinichi Kako
  • Junji Nishida
  • Hidekazu Tsunoda
  • Yoshio Omori
  • Masanori Nakazawa
  • Osamu Tanaka
Original Article

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.

Keywords

Hematopoietic stem cell transplantation Fertility Total body irradiation Shielding Ovarian function 

Notes

Acknowledgments

Authors thank Shinobu Nakabayashi, Hitoshi Matsuzaki, and Masato Sagehashi for their expert technical support to perform ovarian shielding.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Yoshinobu Kanda
    • 1
  • Hidenori Wada
    • 1
  • Ryoko Yamasaki
    • 1
  • Koji Kawamura
    • 1
  • Yuko Ishihara
    • 1
  • Kana Sakamoto
    • 1
  • Masahiro Ashizawa
    • 1
  • Miki Sato
    • 1
  • Tomohito Machishima
    • 1
  • Kiriko Terasako-Saito
    • 1
  • Shun-ichi Kimura
    • 1
  • Hideki Nakasone
    • 1
  • Misato Kikuchi
    • 1
  • Rie Yamazaki
    • 1
  • Junya Kanda
    • 1
  • Shinichi Kako
    • 1
  • Junji Nishida
    • 1
  • Hidekazu Tsunoda
    • 2
  • Yoshio Omori
    • 2
  • Masanori Nakazawa
    • 3
  • Osamu Tanaka
    • 2
  1. 1.Division of Hematology, Saitama Medical CenterJichi Medical UniversitySaitamaJapan
  2. 2.Department of Radiology, Saitama Medical CenterJichi Medical UniversitySaitamaJapan
  3. 3.Department of RadiologyJichi Medical UniversityTochigiJapan

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