11例血液病患者卵巢组织冻存生育力保护的临床病例分析

Clinical analysis of 11 cases of ovarian tissue cryopreservation in patients with hematological diseases

目的探讨血液病患者行卵巢组织冻存(ovarian tissue cryopreservation,OTC)保护生育力的可行性及该手术对患者行造血干细胞移植(hematopoietic stem cell transplantation,HSCT)的影响。方法回顾性分析2017年4月至2021年7月于北京大学人民医院收治的11例行OTC的血液病患者的临床资料。结果11例血液病患者平均年龄为(23.2±2.9)岁(18~31岁),其中10例为恶性血液病,包括6例急性髓系白血病、3例急性淋巴细胞白血病、1例骨髓异常增生综合征;1例再生障碍性贫血。10例行腹腔镜下双侧卵巢部分切除术,1例行腹腔镜下单侧卵巢切除术。平均手术时间(58.8±13.5)min(41~82 min),平均术中出血量(44.5±51.9)mL(10~200 mL)。术后患者血常规及凝血功能无明显变化,均无感染、出血等并发症。11例患者术后均行HSCT,距HSCT前预处理时间为(37.5±25.7)d(10~82 d),4例在术后20 d内开始HSCT前预处理。结论卵巢组织冻存对血液病患者原发病情无明显影响,不推迟患者HSCT治疗,是年轻血液病患者生育力保护的有效手段。

Objective To investigate the feasibility of ovarian tissue cryopreservation(OTC)in patients with hematological diseases and the impact of OTC on hematopoietic stem cell transplantation(HSCT).Methods The clinical data of eleven cases of patients with hematological diseases undergoing OTC admitted to Peking University People’s Hospital from April 2017 to July 2021 were retrospectively analyzed.Results The average age of 11 patients was(23.2±2.9)years(18~31 years).10 patients had hematologic malignancy,including 6 acute myeloid leukemia,3 acute lymphoblastic leukemia,and 1 myelodysplastic syndrome.1 patient had aplastic anemia.10 patients received laparoscopic bilateral partial ovariectomy,one underwent laparoscopic unilateral ovariectomy.The average time of OTC was(58.8±13.5)minutes(41~82 minutes),and the average intraoperative bleeding was(44.5±51.9)mL(10~200 mL).There were no significant changes in hemogram and coagulation index and no complications such as infection and bleeding after surgery.All patients underwent HSCT after surgery.The time from OTC to pretreatment of HSCT was(37.5±25.7)days(10~82 days).4 patients began HSCT pretreatment within 20 days after OTC.Conclusions OTC has no adverse effect on patients with hematological diseases and does not delay HSCT treatment.For young patients with hematological diseases,OTC is an effective way to preserve fertility.