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血液系统恶性肿瘤女性患者生育力保存的进展

Advances in fertility preservation of female patients with hematological malignancies.

作者信息

Salama Mahmoud, Isachenko Vladimir, Isachenko Evgenia, Rahimi Gohar, Mallmann Peter

机构信息

a Department of Gynecology and Obstetrics, Medical Faculty , University of Cologne , Cologne , Germany.

出版信息

Expert Rev Hematol. 2017 Nov;10(11):951-960. doi: 10.1080/17474086.2017.1371009. Epub 2017 Aug 28.

Abstract

The most common forms of hematological malignancies that occur in female reproductive years are lymphoma and leukemia. Areas covered: Several aggressive gonadotoxic regimens such as alkylating chemotherapy and total body irradiation are used frequently in treatment of lymphoma and leukemia leading to subsequent iatrogenic premature ovarian failure and fertility loss. In such cases, female fertility preservation options should be offered in advance. Expert commentary: In order to preserve fertility of young women and girls with lymphoma and leukemia, several established, experimental, and debatable options can be offered before starting chemotherapy and radiotherapy. However, each of those female fertility preservation options has both advantages and disadvantages and may not be suitable for all patients. That is why a fertility preservation strategy should be individualized and tailored distinctively for each patient in order to be effective. Artificial human ovary is a novel experimental in vitro technology to produce mature oocytes that could be the safest option to preserve and restore fertility of young women and girls with hematological malignancies especially when other fertility preservation options are not feasible or contraindicated. Further research and studies are needed to improve the results of artificial human ovary and establish it in clinical practice.

摘要

女性生殖年龄段最常见的血液系统恶性肿瘤形式是淋巴瘤和白血病。涵盖领域:在淋巴瘤和白血病的治疗中,经常使用几种具有侵袭性的性腺毒性方案,如烷化剂化疗和全身照射,这会导致随后的医源性过早卵巢功能衰竭和生育能力丧失。在这种情况下,应提前提供女性生育力保存选择。专家评论:为了保留患有淋巴瘤和白血病的年轻女性和女孩的生育能力,在开始化疗和放疗之前,可以提供几种既定的、实验性的和有争议的选择。然而,这些女性生育力保存选择中的每一种都有其优缺点,可能并不适用于所有患者。这就是为什么生育力保存策略应该针对每个患者进行个性化和独特定制,以便有效。人工人卵巢是一种新型的体外实验技术,用于产生成熟卵母细胞,这可能是保留和恢复患有血液系统恶性肿瘤的年轻女性和女孩生育力的最安全选择,特别是当其他生育力保存选择不可行或禁忌时。需要进一步的研究来改善人工人卵巢的效果并将其应用于临床实践。

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