Fertility preservation in Hodgkin's lymphoma patients that undergo targeted molecular therapies: an important step forward from the chemotherapy era.
Fertility preservation in Hodgkin's lymphoma patients that undergo targeted molecular therapies: an important step forward from the chemotherapy era.
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DOI：
10.2147/cmar.s154819
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发表时间：
2018
影响因子：
3.3
通讯作者：
Micu R
中科院分区：
文献类型：
--
作者：
Traila A;Dima D;Achimas-Cadariu P;Micu R
总的来说，80%-90%的霍奇金淋巴瘤（HL）患者可以通过联合放化疗治愈。由于治疗策略的改进，50%的复发/难治性患者可能经历完全的临床反应并有长期生存。HL的治疗方案是有效的，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）咨询和生育能力保存作为治疗选择。在过去的几年中，新的靶向分子已可用于HL治疗。这些新药在大量预先治疗的患者中显示出很高的总体反应率，其中大多数患者在自体干细胞移植后复发，这一群体以前被认为是非常低的风险。高达50%的患者有完全缓解和改善的总生存期。未来的研究将解决新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的高反应和生存率，生育已成为长期HL幸存者关注的问题。随着抗逆转录病毒治疗方面的进展，以及为HL患者制定的严格步骤，更多的幸存者将成为父母。
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.