Follicle density in ovarian samples not affected by age or ABVD in young women

Ovarian tissue samples, harvested from young women undergoing treatment for Hodgkin's lymphoma, are not affected by up to six cycles of ABVD treatment and show no evidence of lymphoma cells, a Victorian study shows.Hodgkin's lymphoma (HL) is common in young people, and there is a risk of infertility and premature ovarian failure after chemotherapy. Ovarian cryopreservation after laparoscopic removal has the potential to give better future fertility compared with oocyte preservation, but most data has come from animal studies or case reports. There is also a risk of disease re-implantation. In this Victorian retrospective analysis, 26 ovarian tissue samples that were harvested for cryopreservation from women with HL were assessed for subclinical involvement by HL using histology to identify characteristic Reed Sternberg cells, and by immunohistochemistry using CD 15 and CD30 markers. Follicle density in the tissue was also measured. Disease status and details of the chemotherapy used were available for 24 of the patients. The age range was 13-29 years (median 22 years). Seven of 24 patients had infradiaphragmatic disease at time of harvest. Nine of 20 patients had received chemotherapy preharvest, seven with adriamycin, bleomycin, vinblastine and dacarbazine (ABVD), and two with other regimens. Results showed that in the seven patients receiving up to six cycles of ABVD there was no difference in follicle density compared to 14 patients who were not receiving treatment. The follicle density ranged from 45-4512 follicles/mm3, and there was no correlation with patient age. There was no evidence of HL involvement in the 26 samples examined and no other atypical findings. The authors concluded that subclinical involvement of HL was not identified in the ovarian tissue, even when patients had infradiaphragmatic disease, and that the quality of tissue harvested was not adversely affected by the patient's age or previous ABVD chemotherapy.The noted the proviso that a single biopsy may not be adequate to exclude HL in the whole ovary and that random examination of several slices should be considered. Further, none of the patients had their ovarian tissue reimplanted and it was not clear if prior chemotherapy would affect the ability to reimplant.Reference...