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淋巴增生性肿瘤的性腺毒性和生育力保护的新方面。

Novel aspects on gonadotoxicity and fertility preservation in lymphoproliferative neoplasms.

机构信息

Gynecologic Oncology Unit, IRCCS Istituto Tumori "Giovanni Paolo II" 70124 Bari, Italy.

Gynecologic Oncology Unit, IRCCS Istituto Tumori "Giovanni Paolo II" 70124 Bari, Italy; Department of Biomedical Sciences and Human Oncology, Unit of Obstetrics and Gynecology, University of Bari Aldo Moro, Bari, Italy.

出版信息

Crit Rev Oncol Hematol. 2020 Jul;151:102981. doi: 10.1016/j.critrevonc.2020.102981. Epub 2020 May 15.

Abstract

The topic of fertility preservation in patients with a lymphoproliferative disease offers new aspects of debate, due to the introduction of novel chemotherapeutic regimens and small molecules in the clinical landscape. Cancer related infertility is mostly dependent on gonadotoxic treatments and fertile female patients are today addressed to the oocyte cryopreservation or to ovarian cortex fragment cryopreservation. These methods present advantages and disadvantages, which will be discussed in the present review, together with the options for male patients. The recent discovery of functional ovarian stem cells (OCSs) in woman ovarian cortex, opens new avenues offering a innovative procedure for fertility preservation through as model of regenerative medicine. Here, we review the gonadotoxic potential of "classical" chemotherapeutic treatments as well as of "novel" targeted therapies actually employed for lymphoproliferative neoplasms in young patients and revisit both the today available and future chances to preserve and restore fertility after the cancer healing.

摘要

在淋巴增生性疾病患者中进行生育力保存的话题提出了新的争论点,这是由于新型化疗方案和小分子药物在临床应用中的引入。癌症相关的不孕主要取决于性腺毒性治疗,因此有生育能力的女性患者可以选择卵母细胞冷冻保存或卵巢皮质碎片冷冻保存。这些方法各有优缺点,本文将对其进行讨论,并介绍男性患者的选择。最近在女性卵巢皮质中发现功能性卵巢干细胞(OCS),为生育力保存开辟了新途径,为再生医学提供了一种创新的方法。在这里,我们回顾了“经典”化疗药物以及目前用于治疗年轻患者淋巴增生性肿瘤的“新型”靶向治疗的性腺毒性作用,并重新探讨了癌症治愈后,现有和未来的生育力保存和恢复的机会。

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