Müller U, Stahel R A
Department of Medicine, University Hospital, Zürich, Switzerland.
Ann Oncol. 1993 May;4(5):399-402. doi: 10.1093/oxfordjournals.annonc.a058519.
The late effects of chemotherapy of aggressive non-Hodgkin's lymphoma on gonadal function are largely unknown.
In a retrospective study the gonadal function after chemotherapy with MACOP-B or VACOP-B with or without dose intensification and ABMT in first remission was examined in patients with aggressive non-Hodgkin's lymphoma by patient history and determination of hormonal function. Thirty adult patients of age 40 or less at diagnosis who were alive and free of relapse for at least 1 year after completion of chemotherapy were included in the study.
With a median time of 28 months (range 11 to 62 months) after completion of therapy, gonadal dysfunction was found in 1 of 7 female and none of 15 male patients, or a total of 5% of patients treated with chemotherapy alone. Of patients receiving dose intensification and ABMT in first remission, gonadal dysfunction was present in 2/6 (33%) treated with cyclophosphamide, BCNU and etoposide in 3/4 treated with cyclophosphamide and TBI.
Our data suggest that therapy of aggressive non-Hodgkin's lymphomas with MACOP-B or VACOP-B has little impact on future fertility and that fertility may be preserved in the majority of patients receiving dose-intensification with CBV in first remission.
侵袭性非霍奇金淋巴瘤化疗对性腺功能的远期影响很大程度上尚不清楚。
在一项回顾性研究中,通过病史及激素功能测定,对侵袭性非霍奇金淋巴瘤患者在首次缓解期接受MACOP-B或VACOP-B化疗(有或无剂量强化及自体骨髓移植)后的性腺功能进行了检查。研究纳入了30例诊断时年龄40岁及以下、化疗结束后存活且无复发至少1年的成年患者。
治疗结束后中位时间为28个月(范围11至62个月),7例女性患者中有1例出现性腺功能障碍,15例男性患者中无1例出现,即单纯接受化疗的患者中共有5%出现性腺功能障碍。在首次缓解期接受剂量强化及自体骨髓移植的患者中,接受环磷酰胺、卡氮芥和依托泊苷治疗的患者中有2/6(33%)出现性腺功能障碍,接受环磷酰胺和全身照射治疗的患者中有3/4出现性腺功能障碍。
我们的数据表明,采用MACOP-B或VACOP-B治疗侵袭性非霍奇金淋巴瘤对未来生育能力影响很小,并且在首次缓解期接受CBV剂量强化治疗的大多数患者中生育能力可能得以保留。