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接受靶向分子治疗的霍奇金淋巴瘤患者的生育力保存:化疗时代向前迈出的重要一步。

Fertility preservation in Hodgkin's lymphoma patients that undergo targeted molecular therapies: an important step forward from the chemotherapy era.

作者信息

Traila Alexandra, Dima Delia, Achimas-Cadariu Patriciu, Micu Romeo

机构信息

School of Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj Napoca, Romania.

Department of Surgical Oncology, Ion Chiricuta Oncology Institute, Cluj Napoca, Romania.

出版信息

Cancer Manag Res. 2018 Jun 13;10:1517-1526. doi: 10.2147/CMAR.S154819. eCollection 2018.

Abstract

In total, 80%-90% of Hodgkin's lymphoma (HL) patients are curable with combination chemoradiotherapy. Due to improvements in therapeutic strategies, 50% of all relapsed/refractory patients may undergo complete clinical responses and have long-term survival. Treatment options for HL are effective, but may have a negative impact on post-chemotherapy fertility. Thus, cryopreservation of semen prior to treatment is recommended for male patients. For female patients, assisted reproductive techniques (ART) consult and fertility preservation should be offered as a therapeutical option. In the last years, new targeted molecules have been available for HL treatment. These new drugs showed a high rate of overall responses in the setting of heavily pretreated patients, most of them in relapse after autologous stem cell transplantation, a group previously considered very poor risk. Up to 50% of patients have a complete response and an improved overall survival. Future studies will address the usefulness of novel molecules as a frontline therapy. Considering the high response and survival rates with monoclonal antibody-based therapeutics, fertility has become a concerning issue for long-term HL survivors. As progress has been made regarding ART, with the rigorous steps planned for HL patients, more survivors will become parents.

摘要

总体而言,80% - 90%的霍奇金淋巴瘤(HL)患者可通过联合放化疗治愈。由于治疗策略的改进,所有复发/难治性患者中有50%可能实现完全临床缓解并长期存活。HL的治疗方案有效,但可能对化疗后的生育能力产生负面影响。因此,建议男性患者在治疗前冷冻保存精液。对于女性患者,应提供辅助生殖技术(ART)咨询和生育力保存作为一种治疗选择。在过去几年中,有新的靶向分子可用于HL治疗。这些新药在经过大量预处理的患者中显示出较高的总体缓解率,其中大多数是自体干细胞移植后复发的患者,这一群体以前被认为风险极高。高达50%的患者有完全缓解且总生存期得到改善。未来的研究将探讨新型分子作为一线治疗的有效性。考虑到基于单克隆抗体的治疗方法具有较高的缓解率和生存率,生育能力已成为长期HL幸存者关注的问题。随着ART取得进展,以及为HL患者规划的严格步骤,更多的幸存者将成为父母。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f864/6005299/7420bd3fcbbd/cmar-10-1517Fig1.jpg

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