Journal Article

7826 A single tertiary centre experience of paediatric patients receiving fertility cryopreservation prior to allogeneic haematopoietic stem cell transplant (HSCT)

Slatter, Mary, Roberts, Wing, Nicholson, Karen, Kelly, Chloe, Gabra Hany

2025

Overview

Why did you do this work?Haematopoietic Stem Cell Transplant (HSCT) is used as a treatment for both malignant and non-malignant conditions. Conditioning is given prior to transplant to increase likelihood of engraftment and reduce risk of graft vs host disease (GvHD), this can be in the form of radiation, chemotherapy, or a combination of both.1 These conditioning regimens often lead to poor reproductive outcomes for both males and females.2 Fertility cryopreservation is a procedure carried out prior to HSCT in which the ovaries and testicular tissue in females and males respectively, are frozen so they can be re-transplanted later in life if fertility is an issue.What did you do?This is a retrospective study of male and female paediatric patients receiving fertility cryopreservation between 2020 and 2024 prior to an allogenic HSCT. A total of 28 boys and 29 girls were identified from a total of 186 patients who were transplanted during the selected period. Exclusion criteria included those travelling from overseas to receive treatment, apart from Republic of Ireland, patients receiving cryopreservation at another centre and those lacking documentation of the outcomes of the cryopreservation procedure. Patient notes were accessed, demographics noted and complications of cryopreservation were analysed. Patient age at cryopreservation ranged from 2 months to 16 years 4 months.What did you find?Both the numbers of males transplanted and fertility cryopreservation increased yearly during the trial period, however the percentage of boys undergoing cryopreservation increased at a faster rate, see figure 1. The rates in girls did not change , which is to be expected as cryopreservation is an established treatment in girls but not boys, meaning parents are less willing to consent to an experimental procedure. The main complication experienced post fertility cryopreservation surgery was pain which was experienced in 46% (n = 13) boys and 58% (n = 18) of girls. As demonstrated in figure 2, the length of time pain was experienced was usually shorter for female patients, when compared to male patients. Other complications included soft tissue injury, bleeding and wound infection – these were significantly more common in the male than the female cohorts.What does it mean?This audit highlights the rate of complications after fertility cryopreservation in paediatric patients is relatively high, however for the most part these were minor. It has shown that documentation of pain, bruising and any other complications should be assessed, treated and documented clearly. This data can be used to better inform families of what they may experience following a cryopreservation procedure so they are able to make more well informed decisions and reduce the anxiety they experience when complications occur.Abstract 7826 Figure 1%HSCT receiving fertility cryopreservation[Image Omitted. See PDF.]Abstract 7826 Figure 2Days complaining of pain[Image Omitted. See PDF.]ReferencesNagler A, Shimoni A. The EBMT Handbook: Hematopoietic Stem Cell Transplantation and Cellular Therapies, Chapter 13. 2019Wikander I, Lundberg FE, Nilsson H, Borgström, Rodriguez-Wallberg KA. A prospective study on fertility preservation in prepubertal and adolescent girls undergoing hematological stem cell transplantation. 2021 Jun 30.

• Publisher: BMJ Publishing Group LTD
• Subject: Cell therapy / Chemotherapy / Children & youth / Cryopreservation / Documentation / Females / Fertility / Girls / Graft-versus-host reaction / Hematopoietic stem cells / Males / Pain / Patients / Pediatrics / Stem cell transplantation / Stem cells / Wound infection