MACS and acellular autologous non-ovarian tissue scaffolds: a promising strategy for safe and efficient follicle transplantation in hematologic cancer

BACKGROUND: Advances in ovarian tissue cryopreservation offer new hope for young hematologic cancer patients. However, the risk of cancer cell reintroduction during transplantation remains a major concern, necessitating both effective tumor cell removal strategies and biocompatible scaffold development. METHODS: We characterized decellularized adipose, peritoneal, and ovarian tissue scaffolds through H&E staining, immunofluorescence, SEM, and proliferation assays. Magnetic-activated cell sorting (MACS) efficiency was evaluated for reducing hematologic malignancy contamination. Follicle function was assessed via immunofluorescence and ELISA, while RNA-seq and qPCR compared gene expression across scaffolds. RESULTS: Sodium dodecyl sulfate (SDS) decellularization effectively preserved extracellular matrix architecture across all tissues. In lipopolysaccharide (LPS)-induced leukocytosis models, MACS significantly reduced leukocyte contamination (p < 0.0001). Comparable follicle growth and hormone production (estrogen/progesterone/inhibin) were observed across scaffolds. RNA-seq analysis identified subtle differential expression in a small subset of follicle function-related genes, while the majority of genes exhibited conserved expression patterns across scaffolds. CONCLUSION: The results demonstrate that MACS effectively prevents tumor cell transmission during follicle transplantation. All decellularized scaffolds exhibited high follicular biocompatibility in this animal model, with non-ovarian scaffolds emerging as promising autologous alternatives for artificial ovary engineering.