31例异基因造血干细胞移植前儿童卵巢组织冻存的研究  

Cryopreservation of ovarian tissue in pediatric girls undergoing allogeneic hematopoietic stem cell transplantation:31 cases report

作　　者：陈姣 阮祥燕[2] 孙清政 刘周阳 姜帆 樊世芬 吕琳琳 孙媛 CHEN Jiao;RUAN Xiangyan;SUN Qingzheng;LIU Zhouyang;JIANG Fan;FAN Shifen;LV Linlin;SUN Yuan(Beijing JingDu Children′s Hospital,Beijing 102208,China;Beijing Obstetrics and Gynecology Hospital,Capital Medical University,Beijing 102206,China)

机构地区：[1]北京京都儿童医院,北京102208 [2]首都医科大学附属北京妇产医院,北京100026

出　　处：《中国小儿血液与肿瘤杂志》2024年第5期322-326,共5页Journal of China Pediatric Blood and Cancer

摘　　要：目的 了解卵巢组织冻存(OTC)过程、卵巢取材手术对造血干细胞移植(HSCT)的影响及冻存效果。方法 回顾性分析2021年10月—2024年1月北京京都儿童医院31例异基因HSCT前行OTC的病例资料,并复习相关文献。结果 31例患儿中位年龄6(7个月-15岁)岁,中位体重22(7.2-77.2)kg。急性白血病8例,慢性活动性EB病毒感染6例,免疫缺陷6例,再生障碍性贫血5例,舒-戴二氏综合征2例,噬血细胞综合征2例,黏脂质贮积病和骨髓增生异常综合征各1例。5例行双孔或三孔腹腔镜手术,26例行单孔腹腔镜手术。31例均单侧卵巢切除,在首都医科大学附属北京妇产医院卵巢组织冻存库冻存。12人接受过影响性腺的化疗,卵泡活性计数为(744.08±691.299)个;19人未接受过影响性腺的化疗,卵泡活性计数为(340.21±445.302)个(P=0.182)。手术和HSCT预处理间隔中位时间11.5(3-92)天。31例(100%)均未发生手术部位感染;30例(96.8%)未发生手术部位出血。30例已完成HSCT,均植入成功。结论 OTC是HSCT前保护生育力及卵巢内分泌功能的安全有效方式,手术前已行化疗的患者HSCT前仍有卵巢组织冻存机会。Objective To explore process and effects of ovarian tissue cryopreservation(OTC),and to observe impact of the surgery to obtain ovarian tissue on hematopoietic stem cell transplantation(HSCT).Methods A total of 31 patients who cryopreserved ovarian tissue before allogeneic HSCT(allo-HSCT) in Beijing Jingdu Children′s Hospital from October 2021 to January 2024 were enrolled.The clinical data were analyzed retrospectively.Results The median age and weight of patients were 6 years old(ranged from 7 months to 17 years) and 22 kg(ranged from 7.2 to 77.2 kg).The diagnosis included 8 cases of acute leukemia,6 cases of chronic active Epstein-Barr virus infection,6 cases of immune deficiency,5 cases of aplastic anemia,2 cases of Shwachman-Diamond syndrome,2 cases of hemophagocytic syndrome,1 case each of mucolipidosis and myelodysplastic syndrome.Five cases underwent double or triple port laparoscopic surgery,and 26 cases underwent single port laparoscopic surgery.Unilateral ovaries of 31 patients were all obtained by laparoscopy and immediately transferred to Beijing Obstetrics and Gynecology Hospital for cryopreservation.The follicle count was 744.08±691.299 in group who had received gonad toxic chemotherapy and 340.21±445.302 in group who had not received gonad toxic chemotherapy(P=0.182).The median interval between surgery and HSCT conditioning was 11.5(3-92) days.None of the 31 patients had infection of surgical site,only 1 patient had hemorrhage,30 patients had completed HSCT and all successfully implanted.Conclusions OTC is a safe and effective way to protect fertility and endocrine function of ovarian before HSCT.Patients who received chemotherapy still have the opportunity and significance to cryopreserve ovarian tissue before HSCT.

关 键 词：造血干细胞移植 卵巢组织冻存 腹腔镜手术 化疗 生育力保护 

分 类 号：R457.7[医药卫生—治疗学]