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Fertility preservation for patients with hematologic malignancies: The Korean Society for Fertility Preservation clinical guidelines

  • Lee, Dong-Yun (Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Kim, Seul Ki (Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital) ;
  • Kim, Miran (Department of Obstetrics and Gynecology, Ajou University School of Medicine) ;
  • Hwang, Kyung Joo (Department of Obstetrics and Gynecology, Ajou University School of Medicine) ;
  • Kim, Seok Hyun (Department of Obstetrics and Gynecology, Seoul National University College of Medicine)
  • Received : 2017.02.28
  • Accepted : 2017.03.28
  • Published : 2017.12.31

Abstract

Although the survival rate of hematologic malignancies in young patients is very high, cytotoxic therapies such as chemotherapy and total body irradiation therapy can significantly reduce a patient's reproductive capacity and cause irreversible infertility. Early ovarian failure also commonly occurs following additional cancer treatment, bone marrow transplantation, or autologous transplantation. Because the risk of early ovarian failure depends on the patient's circumstances, patients with a hematologic malignancy must consult health professionals regarding fertility preservation before undergoing treatments that can potentially damage their ovaries. While it is widely known that early menopause commonly occurs following breast cancer treatment, there is a lack of reliable study results regarding fertility preservation during hematologic malignancy treatment. Therefore, an in-depth discussion between patients and health professionals about the pros and cons of the various options for fertility preservation is necessary. In this study, we review germ cell toxicity, which occurs during the treatment of hematologic malignancies, and propose guidelines for fertility preservation in younger patients with hematologic malignancies.

References

  1. Miller KD, Siegel RL, Lin CC, Mariotto AB, Kramer JL, Rowland JH, et al. Cancer treatment and survivorship statistics, 2016. CA Cancer J Clin 2016;66:271-89. https://doi.org/10.3322/caac.21349
  2. Inaba H, Greaves M, Mullighan CG. Acute lymphoblastic leukaemia. Lancet 2013;381:1943-55. https://doi.org/10.1016/S0140-6736(12)62187-4
  3. Green DM, Kawashima T, Stovall M, Leisenring W, Sklar CA, Mertens AC, et al. Fertility of female survivors of childhood cancer: a report from the childhood cancer survivor study. J Clin Oncol 2009;27:2677-85. https://doi.org/10.1200/JCO.2008.20.1541
  4. Barton SE, Najita JS, Ginsburg ES, Leisenring WM, Stovall M, Weathers RE, et al. Infertility, infertility treatment, and achievement of pregnancy in female survivors of childhood cancer: a report from the Childhood Cancer Survivor Study cohort. Lancet Oncol 2013;14:873-81. https://doi.org/10.1016/S1470-2045(13)70251-1
  5. Carter A, Robison LL, Francisco L, Smith D, Grant M, Baker KS, et al. Prevalence of conception and pregnancy outcomes after hematopoietic cell transplantation: report from the Bone Marrow Transplant Survivor Study. Bone Marrow Transplant 2006;37:1023-9. https://doi.org/10.1038/sj.bmt.1705364
  6. Rossi BV, Missmer S, Correia KF, Wadleigh M, Ginsburg ES. Ovarian reserve in women treated for acute lymphocytic leukemia or acute myeloid leukemia with chemotherapy, but not stem cell transplantation. ISRN Oncol 2012;2012:956190.
  7. Assouline E, Crocchiolo R, Prebet T, Broussais F, Coso D, Gamerre M, et al. Impact of reduced-intensity conditioning allogeneic stem cell transplantation on women's fertility. Clin Lymphoma Myeloma Leuk 2013;13:704-10. https://doi.org/10.1016/j.clml.2013.05.014
  8. Abruzzese E, Trawinska MM, Perrotti AP, De Fabritiis P. Tyrosine kinase inhibitors and pregnancy. Mediterr J Hematol Infect Dis 2014;6:e2014028. https://doi.org/10.4084/mjhid.2014.028
  9. Ault P, Kantarjian H, O'Brien S, Faderl S, Beran M, Rios MB, et al. Pregnancy among patients with chronic myeloid leukemia treated with imatinib. J Clin Oncol 2006;24:1204-8. https://doi.org/10.1200/JCO.2005.04.6557
  10. Pye SM, Cortes J, Ault P, Hatfield A, Kantarjian H, Pilot R, et al. The effects of imatinib on pregnancy outcome. Blood 2008;111:5505-8. https://doi.org/10.1182/blood-2007-10-114900
  11. Chen H, Li J, Cui T, Hu L. Adjuvant gonadotropin-releasing hormone analogues for the prevention of chemotherapy induced premature ovarian failure in premenopausal women. Cochrane Database Syst Rev 2011;(11):CD008018.
  12. Behringer K, Thielen I, Mueller H, Goergen H, Eibl AD, Rosenbrock J, et al. Fertility and gonadal function in female survivors after treatment of early unfavorable Hodgkin lymphoma (HL) within the German Hodgkin Study Group HD14 trial. Ann Oncol 2012;23:1818-25. https://doi.org/10.1093/annonc/mdr575
  13. Blumenfeld Z, Patel B, Leiba R, Zuckerman T. Gonadotropin-releasing hormone agonist may minimize premature ovarian failure in young women undergoing autologous stem cell transplantation. Fertil Steril 2012;98:1266-70.e1. https://doi.org/10.1016/j.fertnstert.2012.07.1144
  14. Behringer K, Wildt L, Mueller H, Mattle V, Ganitis P, van den Hoonaard B, et al. No protection of the ovarian follicle pool with the use of GnRH-analogues or oral contraceptives in young women treated with escalated BEACOPP for advanced-stage Hodgkin lymphoma: final results of a phase II trial from the German Hodgkin Study Group. Ann Oncol 2010;21:2052-60. https://doi.org/10.1093/annonc/mdq066
  15. Demeestere I, Brice P, Peccatori FA, Kentos A, Gaillard I, Zachee P, et al. Gonadotropin-releasing hormone agonist for the prevention of chemotherapy-induced ovarian failure in patients with lymphoma: 1-year follow-up of a prospective randomized trial. J Clin Oncol 2013;31:903-9. https://doi.org/10.1200/JCO.2012.42.8185
  16. Demeestere I, Brice P, Peccatori FA, Kentos A, Dupuis J, Zachee P, et al. No evidence for the benefit of gonadotropin-releasing hormone agonist in preserving ovarian function and fertility in lymphoma survivors treated with chemotherapy: final long-term report of a prospective randomized trial. J Clin Oncol 2016;34:2568-74. https://doi.org/10.1200/JCO.2015.65.8864
  17. Demeestere I, Brice P, Peccatori FA, Kentos A, Dupuis J, Zachee P, et al. Reply to M. Lambertini et al. J Clin Oncol 2017;35:805-6. https://doi.org/10.1200/JCO.2016.70.6093
  18. Lambertini M, Falcone T, Unger JM, Phillips KA, Del Mastro L, Moore HC. Debated role of ovarian protection with gonadotropin- releasing hormone agonists during chemotherapy for preservation of ovarian function and fertility in women with cancer. J Clin Oncol 2017;35:804-5. https://doi.org/10.1200/JCO.2016.69.2582
  19. Behringer K, Breuer K, Reineke T, May M, Nogova L, Klimm B, et al. Secondary amenorrhea after Hodgkin's lymphoma is influenced by age at treatment, stage of disease, chemotherapy regimen, and the use of oral contraceptives during therapy: a report from the German Hodgkin's Lymphoma Study Group. J Clin Oncol 2005;23:7555-64. https://doi.org/10.1200/JCO.2005.08.138
  20. Blumenfeld Z, von Wolff M. GnRH-analogues and oral contraceptives for fertility preservation in women during chemotherapy. Hum Reprod Update 2008;14:543-52. https://doi.org/10.1093/humupd/dmn022
  21. Practice Committee of American Society for Reproductive Medicine. Fertility preservation in patients undergoing gonadotoxic therapy or gonadectomy: a committee opinion. Fertil Steril 2013;100:1214-23. https://doi.org/10.1016/j.fertnstert.2013.08.012
  22. Loren AW, Mangu PB, Beck LN, Brennan L, Magdalinski AJ, Partridge AH, et al. Fertility preservation for patients with cancer: American Society of Clinical Oncology clinical practice guideline update. J Clin Oncol 2013;31:2500-10. https://doi.org/10.1200/JCO.2013.49.2678
  23. Cakmak H, Rosen MP. Random-start ovarian stimulation in patients with cancer. Curr Opin Obstet Gynecol 2015;27:215-21. https://doi.org/10.1097/GCO.0000000000000180
  24. Practice Committees of American Society for Reproductive Medicine; Society for Assisted Reproductive Technology. Mature oocyte cryopreservation: a guideline. Fertil Steril 2013;99:37-43. https://doi.org/10.1016/j.fertnstert.2012.09.028
  25. Bastings L, Beerendonk CC, Westphal JR, Massuger LF, Kaal SE, van Leeuwen FE, et al. Autotransplantation of cryopreserved ovarian tissue in cancer survivors and the risk of reintroducing malignancy: a systematic review. Hum Reprod Update 2013;19:483-506. https://doi.org/10.1093/humupd/dmt020
  26. Harris NL, Scully RE. Malignant lymphoma and granulocytic sarcoma of the uterus and vagina: a clinicopathologic analysis of 27 cases. Cancer 1984;53:2530-45. https://doi.org/10.1002/1097-0142(19840601)53:11<2530::AID-CNCR2820531127>3.0.CO;2-J
  27. Kyono K, Doshida M, Toya M, Sato Y, Akahira J, Sasano H. Potential indications for ovarian autotransplantation based on the analysis of 5,571 autopsy findings of females under the age of 40 in Japan. Fertil Steril 2010;93:2429-30. https://doi.org/10.1016/j.fertnstert.2009.08.031
  28. Dolmans MM, Luyckx V, Donnez J, Andersen CY, Greve T. Risk of transferring malignant cells with transplanted frozen-thawed ovarian tissue. Fertil Steril 2013;99:1514-22. https://doi.org/10.1016/j.fertnstert.2013.03.027
  29. Dolmans MM, Yuan WY, Camboni A, Torre A, Van Langendonckt A, Martinez-Madrid B, et al. Development of antral follicles after xenografting of isolated small human preantral follicles. Reprod Biomed Online 2008;16:705-11. https://doi.org/10.1016/S1472-6483(10)60485-3
  30. Turial S, Karabul N, Gutjahr P, Engel V, Bierschock S, Schier F. Ovarian tumours: late extramedullary recurrence of acute leukaemia. Eur J Pediatr Surg 2009;19:184-6. https://doi.org/10.1055/s-2008-1039200
  31. Greve T, Clasen-Linde E, Andersen MT, Andersen MK, Sorensen SD, Rosendahl M, et al. Cryopreserved ovarian cortex from patients with leukemia in complete remission contains no apparent viable malignant cells. Blood 2012;120:4311-6. https://doi.org/10.1182/blood-2012-01-403022
  32. Rosendahl M, Andersen MT, Ralfkiaer E, Kjeldsen L, Andersen MK, Andersen CY. Evidence of residual disease in cryopreserved ovarian cortex from female patients with leukemia. Fertil Steril 2010;94:2186-90. https://doi.org/10.1016/j.fertnstert.2009.11.032
  33. Poirot CJ, Martelli H, Genestie C, Golmard JL, Valteau-Couanet D, Helardot P, et al. Feasibility of ovarian tissue cryopreservation for prepubertal females with cancer. Pediatr Blood Cancer 2007;49:74-8. https://doi.org/10.1002/pbc.21027
  34. Meirow D, Biederman H, Anderson RA, Wallace WH. Toxicity of chemotherapy and radiation on female reproduction. Clin Obstet Gynecol 2010;53:727-39. https://doi.org/10.1097/GRF.0b013e3181f96b54
  35. Meirow D, Schiff E. Appraisal of chemotherapy effects on reproductive outcome according to animal studies and clinical data. J Natl Cancer Inst Monogr 2005;(34):21-5.
  36. Kujjo LL, Chang EA, Pereira RJ, Dhar S, Marrero-Rosado B, Sengupta S, et al. Chemotherapy-induced late transgenerational effects in mice. PLoS One 2011;6:e17877. https://doi.org/10.1371/journal.pone.0017877
  37. Bar-Joseph H, Ben-Aharon I, Rizel S, Stemmer SM, Tzabari M, Shalgi R. Doxorubicin-induced apoptosis in germinal vesicle (GV) oocytes. Reprod Toxicol 2010;30:566-72. https://doi.org/10.1016/j.reprotox.2010.07.003
  38. Imbert R, Moffa F, Tsepelidis S, Simon P, Delbaere A, Devreker F, et al. Safety and usefulness of cryopreservation of ovarian tissue to preserve fertility: a 12-year retrospective analysis. Hum Reprod 2014;29:1931-40. https://doi.org/10.1093/humrep/deu158