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[生育能力的保护和造血干细胞移植 (SFGM-TC) ]
Florian Chevillon1, Marine Rebotier2, Nathalie Dhédin1
1Service hématologie adolescents jeunes adultes, hôpital Saint-Louis, AP-HP, 1, avenue Claude-Vellefaux, 75010 Paris, France.
Bulletin du cancer
|June 25, 2024
概括
造血干细胞移植调节方案可能会影响患者的生育能力. 建议在移植前和移植后保持生育能力,特别是减少强度的调节,以减轻风险.
科学领域:
- 生殖医学是一种生殖医学.
- 血液学 血液学 血液学
- 在瘤学瘤学.
背景情况:
- 血造干细胞移植 (HSCT) 的调节方案使用淋巴细胞辐射和化剂,影响患者的生育能力.
- 生育效应取决于剂量,受患者年龄的影响,特别是在女性中.
- 有限的数据存在于降低强度调节 (RIC) 方案后的生育结果.
研究的目的:
- 为了告知患者关于HSCT调节方案的潜在生育影响.
- 在HSCT之前推生育保存技术.
- 在HSCT后评估淋巴腺功能,特别是在RIC后.
主要方法:
- 审查现有的关于调节方案及其对生育能力的影响的文献.
- 基于患者年龄,病理和条件类型的生育保存技术的讨论.
- 在移植后评估生殖腺功能.
主要成果:
- 骨髓损伤性调节方案造成显著的淋巴细胞毒性,证明了生育能力的保护.
- 尽管理论上阴腺毒性较低,但降低强度的调节方案也保证了生育能力的保护.
- 在用于某些血液性恶性瘤的收获性腺组织时,必须评估瘤细胞再引入的风险.
结论:
- 保持生育能力对于所有接受HSCT的患者至关重要,无论条件强度如何,在医学上可行的情况下.
- 移植前就生育和保存选项进行咨询是必不可少的.
- 建议对移植后的淋巴腺功能进行评估,并讨论如果存在残留功能,则进一步保存.
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