Clinical Pathology Unit, AOU Consorziale Policlinico, Bari, Italy.
Hematology and Stem Cell Transplantation Unit, AOU Consorziale Policlinico, Bari, Italy.
Br J Haematol. 2022 Jan;196(1):110-115. doi: 10.1111/bjh.17767. Epub 2021 Aug 31.
The outcome of patients with Hodgkin lymphoma (HL) has improved significantly in recent years, and now attention is increasingly being focused on the well-being of these young patients. This study aimed to analyse the influence of HL and its treatment on the spermatogenic status of 46 male HL patients with available spermiograms, treated between 2008 and 2016. Analysing prognostic factors at diagnosis, we found that the number of spermatozoa was reduced in stage III-IV; motility and vitality were reduced in stage III-IV and in the presence of B symptoms; and abnormal forms were increased in patients with elevated erythrocyte sedimentation rate (ESR) and low albumin. Furthermore, we found that haematopoietic stem cell transplantation (HSCT) was associated with a severe impairment of fertility in terms of sperm motility. In HL-treated patients who did not undergo HSCT we found a statistically significantly improved fertility in terms of motility. In this study, we found that HSCT induced infertility in the majority of male patients with HL, but that first-line treatment could improve the impaired fertility status caused by disease. Further studies are needed in larger case series to investigate risk factors for impaired fertility at HL diagnosis and after treatment.
近年来，霍奇金淋巴瘤（HL）患者的治疗效果显著改善，现在越来越关注这些年轻患者的健康。本研究旨在分析 46 名可提供精子图的 HL 男性患者的 HL 及其治疗对精子发生状况的影响，这些患者于 2008 年至 2016 年间接受治疗。在诊断时分析预后因素，我们发现 III-IV 期的精子数量减少；III-IV 期和存在 B 症状时，精子活力和活力降低；红细胞沉降率（ESR）升高和白蛋白水平降低的患者异常形态增加。此外，我们发现造血干细胞移植（HSCT）与精子运动严重受损有关。在未接受 HSCT 的 HL 治疗患者中，我们发现精子运动方面的生育力有统计学显著改善。在这项研究中，我们发现 HSCT 导致大多数 HL 男性患者不育，但一线治疗可以改善疾病引起的生育能力受损。需要进一步在更大的病例系列中研究 HL 诊断和治疗后生育能力受损的危险因素。
