paywalled: Risk of transferring malignant cells with transplanted frozen-thawed ovarian tissue

Fertility and Sterility

Volume 99, Issue 6, May 2013, Pages 1514–1522

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"Ovarian tissue cryopreservation and transplantation is a real option to preserve and restore fertility in young cancer patients. However, there is a concern regarding the possible presence of malignant cells in the ovarian tissue, which could lead to recurrence of the primary disease after reimplantation. A review of the existing literature was done to evaluate the risk of transplanting malignant cells in case of the main malignant indications for ovarian tissue cryopreservation. For ovarian tissue from patients with hematologic malignancies, it is of paramount importance to identify minimal residual disease before ovarian tissue transplantation. Indeed, these pathologies, reviewed here in detail, are considered to be most at risk of ovarian metastasis."

Figures and tables from this article (requires subscription to view in full):

Figure 1. Histologic analysis of an ovarian fragment recovered from a mouse after 6 months' grafting (acute lymphoblastic leukemia patients). A human follicle is encircled by a large number of lymphocytes. Normal ovarian stroma is no longer present.

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Figure 2. Ovarian fragments from a non-Hodgkin lymphoma (NHL) patient. (A) Immunohistochemistry anti-CD20 (against NHL cells) is negative in the cortex (blue staining) and positive in the medulla (brown staining). Magnification of the white rectangle is represented in (B) and magnification of the black rectangle in (C). (B) Cells with an enlarged nucleus and patchy chromatin are disseminated in the tissue and stain strongly for anti-CD20. (C) Piece of cancer cell-free cortex. Follicles present in the cortex appear healthy. (D) Another fragment from the same patient shows massive invasion by NHL cells in the cortex.

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Table 1. Patients and pathology characteristics with PCR markers tested on frozen-thawed ovarian tissue.

Note: Table showing the number of chronic myeloid leukemia (CML) and acute lymphoblastic leukemia (ALL) patients, their age at the time of ovarian tissue cryopreservation (OTC), and the type of gonadotoxic chemotherapy received before OTC (CML patients received hydroxycarbamide with or without imatinib). Molecular markers present in blood or bone marrow at the time of diagnosis were tested by polymerase chain reaction (PCR) on frozen-thawed ovarian tissue. Adapted from Dolmans et al. (9). Ig = immunoglobulin; NA = not applicable; TCR = T-cell receptor.

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Table 2. Experimental studies on the risk of transmitting malignant cells in case of lymphoma.

Note: Experiments are divided into two groups, depending on whether ovarian tissue from Hodgkin lymphoma (HL) or non-Hodgkin lymphoma (NHL) patients was used. All studies used histology, and some were completed by the addition of either immunohistochemistry or xenografting experiments. One study reported autografting results.

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Table 3. Risk of ovarian metastasis according to cancer type.

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