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07.04.2020 | short report | Ausgabe 7-8/2020 Open Access

Wiener klinische Wochenschrift 7-8/2020

Nature’s endless wonder: unexpected motherhood after pediatric allogeneic stem cell transplantation and severe late effects

Zeitschrift:
Wiener klinische Wochenschrift > Ausgabe 7-8/2020
Autoren:
Dorothea Bauer, Raffaela Tüchler, Daniela Dörfler, MD Anita Lawitschka
Wichtige Hinweise
Dorothea Bauer and Raffaela Tüchler contributed equally to the manuscript.

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Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Summary

Infertility and endocrine late effects (LE) are common sequelae after pediatric allogeneic hematopoietic stem cell transplantation (HSCT) after myeloablative conditioning. Nevertheless, the individual risk for these LE is not always easy to predict and therefore these issues are of ongoing interest to the clinical research community dealing with HSCT aftercare. This article describes the case of a young woman who received polychemotherapy and total body irradiation (TBI) containing conditioning for HSCT for a relapsed anaplastic large cell lymphoma (ALCL). She developed severe sclerotic chronic graft-versus-host disease (GVHD) with irreversible joint contractures and multiorgan involvement, requiring long-term multimodal immunosuppressive treatment. Subsequently showing a considerable number of LE including hypergonadotropic hypogonadism, she accepted that infertility would be quite likely. Her courageous personal life planning included part-time working and a partnership but not motherhood. This article reports the unexpected and spontaneous pregnancy and the extreme preterm birth of a surprisingly adequately developing child.

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