Wang W S, Tzeng C H, Hsieh R K, Chiou T J, Liu J H, Yen C C, Chen P M
Department of Medicine, Veterans General Hospital-Taipei, and National Yang-Ming University School of Medicine, Taiwan, ROC.
Bone Marrow Transplant. 1998 Feb;21(4):415-7. doi: 10.1038/sj.bmt.1701106.
A 22-year-old woman had a normal full-term delivery 6 years after a successful allogeneic bone marrow transplantation (BMT) for acute myeloid leukemia (AML). Conditioning therapy consisted of cyclophosphamide (120 mg/kg) and total body irradiation (TBI) to a total of 1575 cGy in seven fractions (225 cGy x 7, at a dose rate of 3.5 cGy/min). Graft-versus-host disease prophylaxis was with methotrexate and cyclosporin A. Grade I acute GVHD developed after BMT but there was no chronic GVHD. She became amenorrhoeic after BMT and serial gonadal testing indicated hypergonadotrophic hypogonadism. She became pregnant and delivered a full-term, healthy baby 6 years after BMT. Successful pregnancy after TBI of more than 1200 cGy is extremely rare. This case, to the best of our knowledge, is the second patient who received a higher dose of TBI (1575 cGy) to have a successful pregnancy. This and previous reports indicate that normal pregnancy is possible after BMT with TBI in excess of 1200 cGy.
一名22岁女性在因急性髓系白血病（AML）成功接受异基因骨髓移植（BMT）6年后足月顺产。预处理方案包括环磷酰胺（120 mg/kg）和全身照射（TBI），共1575 cGy，分7次进行（225 cGy×7，剂量率为3.5 cGy/分钟）。采用甲氨蝶呤和环孢素A预防移植物抗宿主病。BMT后发生了Ⅰ级急性移植物抗宿主病，但无慢性移植物抗宿主病。BMT后她出现闭经，系列性腺检查提示高促性腺激素性性腺功能减退。她怀孕并在BMT后6年足月分娩了一个健康的婴儿。超过1200 cGy的TBI后成功妊娠极为罕见。据我们所知，该病例是第二例接受更高剂量TBI（1575 cGy）后成功妊娠的患者。该病例及之前的报告表明，超过1200 cGy的TBI进行BMT后正常妊娠是可能的。
