SUCCESSFUL PREGNANCY FOLLOWING VERY HIGH-DOSE TOTAL-BODY IRRADIATION (1575 CGY) AND BONE-MARROW TRANSPLANTATION IN A WOMAN WITH ACUTE MYELOID-LEUKEMIA

A 22-year-old woman had a normal full-term delivery 6 years after a su ccessful allogeneic bone marrow transplantation (BMT) for acute myeloi d 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-ve rsus-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 indicate d 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 o f our knowledge, is the second patient who received a higher dose of T BI (1575 cGy) to have a successful pregnancy, This and previous report s indicate that normal pregnancy is possible after BMT with TBI in exc ess of 1200 cGy.