Reimplantation of cryopreserved ovarian tissue, a technique that has been used successfully in women with lymphoma or solid tumors, may cause disease recurrence in women with leukemia, a new study indicates.
“Our study provides clear evidence that cancer cells in women with acute and chronic leukemias can contaminate the ovaries,” said lead author Marie-Madeleine Dolmans, MD, of the Université Catholique de Louvain, Brussels, Belgium. “If this tissue is reimplanted in these women when they’re ready to have children, there’s a good possibility that the cancer will come back,” she cautioned.
In a study published online in Blood, Dolmans and her colleagues evaluated the presence of leukemic cells in cryopreserved ovarian tissue from 18 women, 12 with acute myeloid leukemia (AML) and six with chronic myeloid leukemia (CML). The patients were between 2 and 31 years old when their ovarian tissue was cryopreserved.
The presence of leukemic cells in cryopreserved ovarian tissue was determined by histology, real-time quantitative polymerase chain reaction (RT-qPCR), and xenografting to immunodeficient mice.
Initial microscopic examination did not reveal any malignant cells in the ovarian tissue samples collected from patients. Using RT-qPCR, however, the researchers found malignant cells in tissue from two of the six CML patients and seven of 10 ALL patients with available molecular markers. In addition, four mice that received ovarian tissue from ALL patients developed tumors during a 6-month observation period.
The researchers conclude that reimplantation of cryopreserved ovarian tissue puts women with AML and CML at risk for disease recurrence, and they note that chemotherapy before cryopreservation does not exclude contamination by malignant cells. Other techniques are needed to preserve fertility in these patients, they say.