Shapira Moran, Raanani Hila, Derech Chaim Sanaz, Meirow Dror
Unit of Fertility Preservation, IVF, Medical Center, Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
Division of Obstetrics and Gynecology, Sheba Medical Center, Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel.
Minerva Ginecol. 2018 Aug;70(4):456-464. doi: 10.23736/S0026-4784.18.04241-7. Epub 2018 Apr 24.
An ongoing increase in survival rates among young leukemia patients is accompanied by a growing attention to possible long-term complications such as chemotherapy induced ovarian insufficiency and infertility. Therefore, an important element of the management of these patients is fertility preservation, which is challenged by considerations specific for leukemia. Such considerations include prepuberty, poor medical condition on presentation and the need for urgent chemotherapy, all of which may preclude the use of conventional assisted reproductive technologies. A restrictive approach towards utilizing cryopreserved ovarian tissue due to the risk for malignancy reintroduction on transplantation, further minimize the options that currently exist for these patients. This paper aims to provide up-to-date knowledge on gonadotoxicity associated with therapy regimens currently used in the treatment of leukemia. Different fertility preservation techniques are discussed, with an emphasis on efficacy, applicability and limitations in the context of leukemia.
年轻白血病患者生存率的持续提高伴随着对化疗诱导的卵巢功能不全和不孕等可能的长期并发症的日益关注。因此，这些患者管理的一个重要因素是生育力保存，而白血病的特殊考虑因素对其构成了挑战。这些考虑因素包括青春期前、就诊时身体状况差以及需要紧急化疗，所有这些都可能排除常规辅助生殖技术的使用。由于移植时存在恶性肿瘤重新植入的风险，对利用冷冻保存的卵巢组织采取限制方法，进一步减少了目前这些患者可用的选择。本文旨在提供有关目前用于治疗白血病的治疗方案相关性腺毒性的最新知识。讨论了不同的生育力保存技术，重点是白血病背景下的疗效、适用性和局限性。
