Department of Medicine A, Meir Medical Centre, Kfar Saba, Israel.
Br J Haematol. 2011 May;153(3):291-308. doi: 10.1111/j.1365-2141.2011.08629.x. Epub 2011 Mar 9.
The improved survival rates among patients with haematological malignancies, such as lymphoma and leukaemia, are shifting areas of focus towards understanding and preventing treatment-induced sequelae. Of these, infertility is one of the most devastating consequences for patients with reproductive potential. The degree of treatment-induced gonadal dysfunction depends on age and gender-related differences, the type and dosage of chemotherapy used and the field and cumulative dose of abdomino-pelvic irradiation. There is also the interesting phenomenon of reduced pre-treatment fertility among male lymphoma patients. At present, the only established methods of fertility preservation are cryopreservation of sperm, oocytes and embryos, as well as gonadal shielding and transposition of ovaries during irradiation. Several other methods, such as cryopreservation and subsequent transplantation of gonadal tissue and the gonadoprotective role of hormonal suppression, are under investigation. Pre-pubertal patients present a unique constellation of fertility considerations, especially as embryo and sperm cryopreservation are not applicable to this age group.
血液系统恶性肿瘤（如淋巴瘤和白血病）患者的生存率提高，使人们的关注点转向了解和预防治疗引起的后遗症。其中，对于有生育能力的患者来说，不孕是最具破坏性的后果之一。治疗引起的性腺功能障碍的程度取决于年龄和性别差异、所用化疗药物的类型和剂量以及腹盆腔放疗的部位和累积剂量。有趣的是，男性淋巴瘤患者在治疗前的生育能力也有所下降。目前，唯一确立的生育力保存方法是冷冻保存精子、卵子和胚胎，以及在放疗期间对性腺进行屏蔽和移位。其他一些方法，如冷冻保存和随后移植性腺组织，以及激素抑制的性腺保护作用，正在研究中。青春期前患者的生育力考虑因素较为独特，特别是因为胚胎和精子冷冻保存不适用于这个年龄段。
