Lee Dong-Yun, Kim Seul Ki, Kim Miran, Hwang Kyung Joo, Kim Seok Hyun
Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam, Korea.
Clin Exp Reprod Med. 2017 Dec;44(4):187-192. doi: 10.5653/cerm.2017.44.4.187. Epub 2017 Dec 31.
Although the survival rate of hematologic malignancies in young patients is very high, cytotoxic therapies such as chemotherapy and total body irradiation therapy can significantly reduce a patient's reproductive capacity and cause irreversible infertility. Early ovarian failure also commonly occurs following additional cancer treatment, bone marrow transplantation, or autologous transplantation. Because the risk of early ovarian failure depends on the patient's circumstances, patients with a hematologic malignancy must consult health professionals regarding fertility preservation before undergoing treatments that can potentially damage their ovaries. While it is widely known that early menopause commonly occurs following breast cancer treatment, there is a lack of reliable study results regarding fertility preservation during hematologic malignancy treatment. Therefore, an in-depth discussion between patients and health professionals about the pros and cons of the various options for fertility preservation is necessary. In this study, we review germ cell toxicity, which occurs during the treatment of hematologic malignancies, and propose guidelines for fertility preservation in younger patients with hematologic malignancies.
尽管年轻患者血液系统恶性肿瘤的生存率很高,但化疗和全身照射疗法等细胞毒性疗法会显著降低患者的生殖能力,并导致不可逆的不孕。在额外的癌症治疗、骨髓移植或自体移植后,早期卵巢功能衰竭也很常见。由于早期卵巢功能衰竭的风险取决于患者的具体情况,血液系统恶性肿瘤患者在接受可能损害卵巢的治疗前,必须就生育力保存问题咨询健康专家。虽然众所周知,乳腺癌治疗后常出现早期绝经,但关于血液系统恶性肿瘤治疗期间生育力保存的可靠研究结果却很缺乏。因此,患者和健康专家有必要深入讨论各种生育力保存选择的利弊。在本研究中,我们回顾了血液系统恶性肿瘤治疗期间发生的生殖细胞毒性,并提出了年轻血液系统恶性肿瘤患者生育力保存的指南。