Minimal Infiltrative Disease Identification in Cryopreserved Ovarian Tissue of Girls with Cancer for Future Use: A Systematic Review

Monika Grubliauskaite, M E Madeleine van der Perk, Annelies M E Bos, Annelot J M Meijer, Zivile Gudleviciene, Marry M van den Heuvel-Eibrink, Jelena Rascon

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Abstract

BACKGROUND: Ovarian tissue cryopreservation and transplantation are the only available fertility techniques for prepubertal girls with cancer. Though autotransplantation carries a risk of reintroducing malignant cells, it can be avoided by identifying minimal infiltrative disease (MID) within ovarian tissue.

METHODS: A broad search for peer-reviewed articles in the PubMed database was conducted in accordance with PRISMA guidelines up to March 2023. Search terms included 'minimal residual disease', 'cryopreservation', 'ovarian', 'cancer' and synonyms.

RESULTS: Out of 542 identified records, 17 were included. Ovarian tissues of at least 115 girls were evaluated and categorized as: hematological malignancies ( n = 56; 48.7%), solid tumors ( n = 42; 36.5%) and tumors of the central nervous system ( n = 17; 14.8%). In ovarian tissue of 25 patients (21.7%), MID was detected using RT-qPCR, FISH or multicolor flow cytometry: 16 of them (64%) being ALL ( IgH rearrangements with/without TRG, BCL-ABL1, EA2-PBX1, TEL-AML1 fusion transcripts), 3 (12%) Ewing sarcoma ( EWS-FLI1 fusion transcript, EWSR1 rearrangements), 3 (12%) CML ( BCR-ABL1 fusion transcript, FLT3) and 3 (12%) AML (leukemia-associated immunophenotypes, BCR-ABL1 fusion transcript) patients.

CONCLUSION: While the majority of malignancies were found to have a low risk of containing malignant cells in ovarian tissue, further studies are needed to ensure safe implementation of future fertility restoration in clinical practice.

Original languageEnglish
Article number4199
Pages (from-to)1-26
JournalCancers
Volume15
Issue number17
DOIs
Publication statusPublished - Sept 2023

Keywords

  • cancer survivors
  • cryopreservation
  • fertility restoration
  • minimal infiltrative disease
  • minimally residual disease
  • ovarian tissue
  • pediatric patients

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