sex-mismatched after stem cell transplant: a case report
D. Ben Salah*a (Dr), F. Loukila (Mlle), F. Mnifa (Pr), M. Elleucha (Dr), M. Abida (Pr)
a chu hedi chaker sfax, Sfax, TUNISIE
* bs.dhoha@gmail.com
introduction:
Ovarian failure associated with stem cell transplantation is generally awarded to total body irradiation and chemotherapeutic agents. The particularity of this observation is that describes a change in cell line in our patient following bone marrow transplant from her HLA matched brother.
Case report:
A 15-year old girl was referred to our department of endocrinology with secondary amenorrhea. She was diagnosed with lymphoblastic Leukemia at the age of 13. She received chemotherapy and total body radiation after which she had bone marrow transplantation.
Patient had menarche at 12 years and 9 months, she had regular menstruations for 5 months. Breast development was automatically since the age of 10 years and physical examination showed normal female genitalia, Tanner stage 3. The hormonal profile showed elevated FSH and LH, low estrogen, and normal prolactin, confirming the POI. Pelvic ultrasound showed a pubertal uterus and two small ovaries without follicles. Bone age was 14 years. Chromosomal analysis was 46, XY.
The cytogenetic analysis carried out on a skin fibroblasts which showed a normal female karyotype identic with her chromosomal analysis before transplantation.
Conclusion:
Ovarian failure is common after allo-stem cell transplant (SCT). It is usually secondary to POI due to chemotherapy. Sex-mismatched after SCT is defined when there is a male donor and female recipient and vice versa, it does not affect fertility. Only the karyotype of hemocyte is 46 XY, but other somatic cells and germ cells are 46 XX as somatic and germ cells originated during the embryonic stage.
L’auteur n’a pas transmis de déclaration de conflit d’intérêt.