Preservation of Fertility and of Reproduction Ability in Lymphoma Patients
Journal
Macedonian Journal of Medical Sciences
Date Issued
2013-05-09
Author(s)
Aleksandar Stojanovic
DOI
https://doi.org/10.3889/mjms.1857-5773.2013.0292
Abstract
Aim: The aim of this article is to provide the health professionals with clear, novel and practical
guidelines regarding management of fertility in patients with malignant hematological disorders, with special accent on lymphoma. Also, it aims at raising consciousness of all physicians administering chemotherapy, about the undesired effects of many chemotherapy regimens, on the reproductive ability, about available methods for preserving fertility and regarding many other issues in connection with fertility in patients treated for lymphoma.
Materials and methods: Online internet databases and publications have been searched, and a
systematic literature review has been performed, using the following keywords: fertility,
chemotherapy as well as relevant keywords in connection to the subject.
Results: Within the search, reports regarding smaller-sized groups, as well as in series of patients
and case reports have been found, but relatively few large randomized studies or actual reports
regarding the success rate and the influence of methods for fertility preservation in patients treated for Hodgkin's and Non-Hodgkin's lymphoma. We have managed in summarizing a large proportion of the research studies and transferring it into an integral multidisciplinary text, offering valid and applicable options for fertility preservation in patients treated for lymphoma. We use the term
lymphoma in general, since the chemotherapy and radiotherapy approaches for Hodgkin's and for
Non-Hodgkin's lymphomas are similar, rendering a major part of the fertility preservation guidelines
appropriate for both entities.
Recommendations: Hematologists should possess fundamental knowledge regarding the late
complications of lymphoma treatment. Besides acknowledging the risk of secondary cancer
development as well as of non-neoplastic cardiac and pulmonary complications, they should be
prepared to raise the issue of infertility as an integral part of the treatment plan, since that is a
complication of significant importance for patients treated with chemotherapy within their
reproductive life period. Possible methods for preserving fertility should be presented and
discussed, and patients should be referred promptly to a reproductive medicine specialist.
Cryopreservation of both sperm and embryos are considered standard practice and are generally
available, while other methods are still in investigational phase and performed in specialized
centers under mandatory professional surveillance and expertise.
Conclusion: It is recommended to utilize treatments that are with as little as possible gonadal
toxicity, to consider a wide array of options for fertility preservation as soon as possible, and to
practice a decision-making process most beneficial for the patient, based on the latest medical
accomplishments and most novel prospects.
guidelines regarding management of fertility in patients with malignant hematological disorders, with special accent on lymphoma. Also, it aims at raising consciousness of all physicians administering chemotherapy, about the undesired effects of many chemotherapy regimens, on the reproductive ability, about available methods for preserving fertility and regarding many other issues in connection with fertility in patients treated for lymphoma.
Materials and methods: Online internet databases and publications have been searched, and a
systematic literature review has been performed, using the following keywords: fertility,
chemotherapy as well as relevant keywords in connection to the subject.
Results: Within the search, reports regarding smaller-sized groups, as well as in series of patients
and case reports have been found, but relatively few large randomized studies or actual reports
regarding the success rate and the influence of methods for fertility preservation in patients treated for Hodgkin's and Non-Hodgkin's lymphoma. We have managed in summarizing a large proportion of the research studies and transferring it into an integral multidisciplinary text, offering valid and applicable options for fertility preservation in patients treated for lymphoma. We use the term
lymphoma in general, since the chemotherapy and radiotherapy approaches for Hodgkin's and for
Non-Hodgkin's lymphomas are similar, rendering a major part of the fertility preservation guidelines
appropriate for both entities.
Recommendations: Hematologists should possess fundamental knowledge regarding the late
complications of lymphoma treatment. Besides acknowledging the risk of secondary cancer
development as well as of non-neoplastic cardiac and pulmonary complications, they should be
prepared to raise the issue of infertility as an integral part of the treatment plan, since that is a
complication of significant importance for patients treated with chemotherapy within their
reproductive life period. Possible methods for preserving fertility should be presented and
discussed, and patients should be referred promptly to a reproductive medicine specialist.
Cryopreservation of both sperm and embryos are considered standard practice and are generally
available, while other methods are still in investigational phase and performed in specialized
centers under mandatory professional surveillance and expertise.
Conclusion: It is recommended to utilize treatments that are with as little as possible gonadal
toxicity, to consider a wide array of options for fertility preservation as soon as possible, and to
practice a decision-making process most beneficial for the patient, based on the latest medical
accomplishments and most novel prospects.
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