Abstract:
Conditioning regimen prior to hematopoietic stem cell transplantation have an impact on patient fertility through the use of gonadal irradiation and/or bifunctional alkylating agents. Their impact on fertility depends mainly on the dose used and, in women, on age at the time of treatment. All patients should benefit before treatment from a consultation informing them of the potential impact on fertility and of fertility preservation techniques. In the absence of contraindications, the major toxicity of myeloablative conditioning regimen justifies fertility preservation. There are few data concerning fertility after reduced-intensity conditioning. Despite lower theoretical gonadotoxicity, we also recommend fertility preservation, if possible before transplantation. The fertility preservation techniques used depend on the patient\'s age, pathology and conditioning. In the event of subsequent use of harvested gonadal tissue in the context of acute leukemia or aggressive lymphoma, it is advisable to assess the risk of reintroduction of tumor cells. Finally, it is recommended to assess gonadal function after transplant, especially after reduced conditioning. If there is persistent residual gonadal function, post-treatment fertility preservation should be discuss.
摘要:
造血干细胞移植前的调理方案通过使用性腺照射和/或双功能烷化剂对患者生育能力有影响。它们对生育的影响主要取决于使用的剂量,在女性中,治疗时的年龄。所有患者应在治疗前受益于咨询,告知他们对生育能力和生育能力保护技术的潜在影响。在没有禁忌症的情况下,清髓性预处理方案的主要毒性证明保留生育力是合理的。强度降低后,关于生育力的数据很少。尽管理论性腺毒性较低,我们还建议保留生育能力,如果可能的话,在移植前。使用的生育力保存技术取决于患者的年龄,病理学和调理。如果随后在急性白血病或侵袭性淋巴瘤的情况下使用收获的性腺组织,建议评估肿瘤细胞重新引入的风险。最后,建议在移植后评估性腺功能,特别是在减少调理后。如果有持续性的残存性腺功能,应讨论治疗后的生育力保护。