OncohematologyOncohematologyОнкогематология1818-83462413-4023Publishing House ABV Press65610.17650/1818-8346-2006-0-1-2-113-120COMPLICATIONS AND THEIR THERAPYОСЛОЖНЕНИЯ И ИХ ТЕРАПИЯReproductive function in female patients with Hodgkin's lymphoma and possibilities of its preservationРепродуктивная функция у пациенток с лимфомой Ходжкина и возможности ее сохраненияPylovaI. V.ПыловаИ. B.
Russian Federation

Москва

DeminaYe. A.ДеминаЕ. А.
Russian Federation

Moscow

Москва

ShmakovR. G.ШмаковР. Г.
Russian Federation

Moscow

Москва

PerilovaYe. Ye.ПериловаЕ. Е.
Russian Federation

Moscow

Москва

N.N.Blokhin Russian Cancer Research Centre, Russian Academy of Medical SciencesРоссийский онкологический научный центр им. Н.Н. Блохина РАМНResearch Centre of Obstetrics, Gynecology and Perinatology, Russian Academy of Medical SciencesНаучный центр акушерства, гинекологии и перинатологии РАМН230520061-2113120231120222006https://oncohematology.abvpress.ru/ongm/article/view/656

The impact of various Hodgkin's lymphoma treatment program on the female reproductive function is discussed. The current Russian and foreign literature on this problem is reviewed. Reproductive function was estimated in 247 females with Hodgkin's lymphoma before and after treatment. The irregular menstrual cycle in untreated group of the females with Hodgkin's lymphoma was significantly more frequent when B-symptoms were present (p = 0.0004). Radiotherapy without irradiation of inguinal and iliac areas did not induce amenorrhea irrespective of age, the number of fields and the cumulative local dose per field (as high as 50 Gy). Irradiation of inguinal and iliac areas induced amenorrhea in all females even when low doses (less than 30 Gy) were used. The ABVD treatment program did not result in steady-state ovarian tissue damage. The therapy schedules containing less than 8 g of cyclophosphamide were less toxic to ovarian tissue amenorrhea occurred only in 10.5% of the women. Treatment by the schedules with doses of cyclophosphamide more than 8 g caused amenorrhea in 26.6% of the patients. A high correlation was found between the incidence of amenorrhea and the patient' age (p = 0.0002): in women above 25 years irreversible ovarian tissue damage was revealed in 48.4% of cases.

/

Hodgkin's lymphomapregnancyamenorrheazoladex1. Гарин А.М. Вклад лекарственной терапии в повышение общей выживаемости онкологических больных. Материалы IX Российского онкологического конгресса. М., 2005. с. 22—4.Гарин А.М. Вклад лекарственной терапии в повышение общей выживаемости онкологических больных. Материалы IX Российского онкологического конгресса. М., 2005. с. 22—4.2. Mauch P., Ng A., Aleman B. et al. Report from Rockefellar Foundation Sponsored International Workshop on reducing mortality and improving quality of life in long-term Survivors of Hodgkin's disease. Eur J Haematol 2005;75(66):68—76.Mauch P., Ng A., Aleman B. et al. Report from Rockefellar Foundation Sponsored International Workshop on reducing mortality and improving quality of life in long-term Survivors of Hodgkin's disease. Eur J Haematol 2005;75(66):68—76.3. Демина Е.А. Лимфома Ходжкина. М., РЛС; 2004. с. 605—14.Демина Е.А. Лимфома Ходжкина. М., РЛС; 2004. с. 605—14.4. Демина Е.А. Современная терапия первичных больных лимфомой Ходжкина. Автореф. дис. … докт. мед. наук.Демина Е.А. Современная терапия первичных больных лимфомой Ходжкина. Автореф. дис. … докт. мед. наук.5. Blumenfeld Z., Dann E., Avivi I., Epelbaum R. Fertility for Hodgkin,s disease. Ann Oncol 2002;13 (Suppl 1): 138—47.Blumenfeld Z., Dann E., Avivi I., Epelbaum R. Fertility for Hodgkin,s disease. Ann Oncol 2002;13 (Suppl 1): 138—47.6. Peters M.V. A study of survival in Hodgkin's disease treated radiologically. Am J Roentgenol 1950;63:299—311.Peters M.V. A study of survival in Hodgkin's disease treated radiologically. Am J Roentgenol 1950;63:299—311.7. Gilbert R. Radiotherapy in Hodgkin's disease (malignant granulomatosis). Anatomic and clinical foundations. Governing principles. Results. Am J Roentgenol 1939;41:198—241.Gilbert R. Radiotherapy in Hodgkin's disease (malignant granulomatosis). Anatomic and clinical foundations. Governing principles. Results. Am J Roentgenol 1939;41:198—241.8. De Vita V., Serpick A. Combination chemotherapy in the treatment of advanced Hodgkin's disease. Proc An Assoc Cancer Res 1967;8:13.De Vita V., Serpick A. Combination chemotherapy in the treatment of advanced Hodgkin's disease. Proc An Assoc Cancer Res 1967;8:13.9. Cancer: Principles and Practice of Oncology. DeVita V.T., Hellman S., Rosenberg S.A. (eds.) 6th ed., Philadelphia, Lippincott-Raven Publishers; 2001. vol 2, ch. 45.Cancer: Principles and Practice of Oncology. DeVita V.T., Hellman S., Rosenberg S.A. (eds.) 6th ed., Philadelphia, Lippincott-Raven Publishers; 2001. vol 2, ch. 45.10. Hodgkin,s disease. Mauch P.V., Armitage J.O., Diehl V. et al. (eds.). Philadelphia, 1999.Hodgkin,s disease. Mauch P.V., Armitage J.O., Diehl V. et al. (eds.). Philadelphia, 1999.11. Шмаков Г.С., Комова Т.Д., Демина Е.А. Беременность и роды у женщин с лимфомой Ходжкина. Материалы VI Российской онкологической конференции. М., 2002. с. 59—60.Шмаков Г.С., Комова Т.Д., Демина Е.А. Беременность и роды у женщин с лимфомой Ходжкина. Материалы VI Российской онкологической конференции. М., 2002. с. 59—60.12. Кулаков В.И. Репродуктивное здоровье населения России: медицинские, социальные и демографические проблемы. Поликлиническая гинекология. М., 2005. с. 263—73.Кулаков В.И. Репродуктивное здоровье населения России: медицинские, социальные и демографические проблемы. Поликлиническая гинекология. М., 2005. с. 263—73.13. Манухин И.Б., Тумилович Л.Г., Геворкян М.А. Физиология репродуктивной системы. В кн.: Клинические лекции по гинекологической эндокринологии. М., 2003. с. 6—26.Манухин И.Б., Тумилович Л.Г., Геворкян М.А. Физиология репродуктивной системы. В кн.: Клинические лекции по гинекологической эндокринологии. М., 2003. с. 6—26.14. Демина Е.А. Лимфогранулематоз. В кн.: Клиническая онкогематология. М., 2001. с. 314—36.Демина Е.А. Лимфогранулематоз. В кн.: Клиническая онкогематология. М., 2001. с. 314—36.15. Glaser S.L. Reproductive factors in Hodgkin,s disease in women: a review. Am J Epidemiol 1994;139:237—46.Glaser S.L. Reproductive factors in Hodgkin,s disease in women: a review. Am J Epidemiol 1994;139:237—46.16. Radford J.A., Shalet S.M., Lieberman B.A. Fertility after treatment for cancer. Br Med J 1999;319:935—6.Radford J.A., Shalet S.M., Lieberman B.A. Fertility after treatment for cancer. Br Med J 1999;319:935—6.17. Демина Е.А., Махова Е.Е., Сусулева Н.А., Ильященко В.А. Возможности сохранения детородной функции у женщин с лимфомой Ходжкина. РМЖ 2005;(1):26—8.Демина Е.А., Махова Е.Е., Сусулева Н.А., Ильященко В.А. Возможности сохранения детородной функции у женщин с лимфомой Ходжкина. РМЖ 2005;(1):26—8.18. Cancer: Principles and Practice of Oncology. DeVita V.T., Hellman S., Rosenberg S.A. (eds.) 4th ed. Philadelphia, 1993. Vol. 2.Cancer: Principles and Practice of Oncology. DeVita V.T., Hellman S., Rosenberg S.A. (eds.) 4th ed. Philadelphia, 1993. Vol. 2.19. Blumenfeld Z., Avivi I., Riter M., Rowe J.M. Preservation of fertility and ovarian function and minimizing chemotherapy-induced gonadotoxicity in young women. J Soc Gynecol Invest 1999;6:229—39.Blumenfeld Z., Avivi I., Riter M., Rowe J.M. Preservation of fertility and ovarian function and minimizing chemotherapy-induced gonadotoxicity in young women. J Soc Gynecol Invest 1999;6:229—39.20. Blumenfeld Z., Haim N. Preservation of gonadal damage during cytotoxic therapy. Ann Med 1997;29:1323—206.Blumenfeld Z., Haim N. Preservation of gonadal damage during cytotoxic therapy. Ann Med 1997;29:1323—206.21. Sutcliffe S.B. Cytotoxic chemotherapy and gonadal function in patients with Hodgkin,s disease. JAMA 1979;242;1898—901.Sutcliffe S.B. Cytotoxic chemotherapy and gonadal function in patients with Hodgkin,s disease. JAMA 1979;242;1898—901.22. Hillier S.G., Zeleznik A.J., Knazek R.A., Ross G.T. Hormonal regulation of preovulatory follicle maturation in the rat. J Reprod Fertil 1980;60(1):219—29.Hillier S.G., Zeleznik A.J., Knazek R.A., Ross G.T. Hormonal regulation of preovulatory follicle maturation in the rat. J Reprod Fertil 1980;60(1):219—29.23. Mattle V., Behringer K., Engert A., Wildt L. Femal fertility after cytotoxic therapy-protection of ovarian function during chemotherapy of malignant and non-malignant diseases. Eur J Haematol 2005; 75(Suppl 66):77—82.Mattle V., Behringer K., Engert A., Wildt L. Femal fertility after cytotoxic therapy-protection of ovarian function during chemotherapy of malignant and non-malignant diseases. Eur J Haematol 2005; 75(Suppl 66):77—82.24. Bittl A., Beck E., Jager W., Wildt L. Untersuchungen zur Amenorrhoe unter adjuvanter CMF-Chemotherapie bei Mammakarzinom-Patientinnen. In: Lang N., Jager W. (eds.). Zytostatikabedingte Nebenwirkungen. Munchen, Zuckschwerdt Verlag; 1993. p. 14—20.Bittl A., Beck E., Jager W., Wildt L. Untersuchungen zur Amenorrhoe unter adjuvanter CMF-Chemotherapie bei Mammakarzinom-Patientinnen. In: Lang N., Jager W. (eds.). Zytostatikabedingte Nebenwirkungen. Munchen, Zuckschwerdt Verlag; 1993. p. 14—20.25. Franchi-Rezgui P., Rousselot P., Espie M. et al. Fertility in young women after chemotherapy with alkylating agents for Hodgkin and non-Hodgkin lymphomas. Hematol J 2003;4(2):116—20.Franchi-Rezgui P., Rousselot P., Espie M. et al. Fertility in young women after chemotherapy with alkylating agents for Hodgkin and non-Hodgkin lymphomas. Hematol J 2003;4(2):116—20.26. Whitehead E., Shalet S.M., Blackledge G. et al. The effect of combination chemotherapy on ovarian function in women treated for Hodgkin's disease. Cancer 1983;52:988—93.Whitehead E., Shalet S.M., Blackledge G. et al. The effect of combination chemotherapy on ovarian function in women treated for Hodgkin's disease. Cancer 1983;52:988—93.27. Behringer K., Breuer K., Reineke T. et al. Secondary amenorrhoea after Hodgkin's lymphoma. A report from the G_rman Hodgkin Lymphoma Study Group (GHSG). Blood 2004;(11): 370a (abstr 1314).Behringer K., Breuer K., Reineke T. et al. Secondary amenorrhoea after Hodgkin's lymphoma. A report from the G_rman Hodgkin Lymphoma Study Group (GHSG). Blood 2004;(11): 370a (abstr 1314).28. Behringer K., Breuer K., Reineke T. 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(30):7555—64.Behringer K., Breuer K., Reineke T. 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(30):7555—64.29. Демина Е.А., Перилова Е.Е., Шмаков Р.Г. Использование комбинированных пероральных контрацептивов для профилактики повреждения функции яичников у больных лимфомой Ходжкина. М., РЛС; 2004. с. 1352—4.Демина Е.А., Перилова Е.Е., Шмаков Р.Г. Использование комбинированных пероральных контрацептивов для профилактики повреждения функции яичников у больных лимфомой Ходжкина. М., РЛС; 2004. с. 1352—4.30. Tesch H., Engert A., Lathan B. et al. Therapy of Hodgkin's disease. Oncologie 1993;16:407—15.Tesch H., Engert A., Lathan B. et al. Therapy of Hodgkin's disease. Oncologie 1993;16:407—15.31. Chartman R.M. Effect of cytotoxic therapy on sexuality and gonadal function. Semin Oncol 1982;9:84—135.Chartman R.M. Effect of cytotoxic therapy on sexuality and gonadal function. Semin Oncol 1982;9:84—135.32. Shafet S.M., Beardwell C.G., Morris P.H. et al. Ovarian failure following abdominal irradiation in childhood. Br J Cancer 1976;33:655—8.Shafet S.M., Beardwell C.G., Morris P.H. et al. Ovarian failure following abdominal irradiation in childhood. Br J Cancer 1976;33:655—8.33. Atay K.M., McKanna J.A., Weintraub A.M. et al. Prevention of chemotherapyinduced ovarian follicular loss in rats. Cancer Res 1985;45:3651—6.Atay K.M., McKanna J.A., Weintraub A.M. et al. Prevention of chemotherapyinduced ovarian follicular loss in rats. Cancer Res 1985;45:3651—6.34. Chapman R.M., Sutcliffe S.B. Protection of ovarian function by oral contraceptives in women receiving chemotherapy for Hodgkin's disease. Blood 1981;58:849—51.Chapman R.M., Sutcliffe S.B. Protection of ovarian function by oral contraceptives in women receiving chemotherapy for Hodgkin's disease. Blood 1981;58:849—51.35. Blumenfeld Z. Ovarian rescue/protection from chemotherapeutic agents. J Soc Gynecol Investig 2001;8:60—4.Blumenfeld Z. Ovarian rescue/protection from chemotherapeutic agents. J Soc Gynecol Investig 2001;8:60—4.36. Blumenfeld Z. Oreservation of fertility and ovarian function and minimalization of chemotherapy associated gonadotoxicity and premature ovarian failure: the role of inhibin-A and -B as markers. Mol Cell Endocrinol 2002;187(1—2):93—105.Blumenfeld Z. Oreservation of fertility and ovarian function and minimalization of chemotherapy associated gonadotoxicity and premature ovarian failure: the role of inhibin-A and -B as markers. Mol Cell Endocrinol 2002;187(1—2):93—105.37. Oktay K., Kan M.T., Rosenwaks Z. Recent progress in oocyte tissue cryopreservation and trasplantation. Curr Opin Obstet Gynecol 2001;13:263—8.Oktay K., Kan M.T., Rosenwaks Z. Recent progress in oocyte tissue cryopreservation and trasplantation. Curr Opin Obstet Gynecol 2001;13:263—8.38. Doll D.C., Ringerberg O.S., Yarbro J.W. Antineoplastic agents and pregnancy. Semin Oncol 1989;16:337—46.Doll D.C., Ringerberg O.S., Yarbro J.W. Antineoplastic agents and pregnancy. Semin Oncol 1989;16:337—46.39. Donnez J., Dolmans M.M., Demylle D. et al. Live birth after orthotopic transplantion of cryopreserved ovarian tissue. Lanset 2000;364:1405—10.Donnez J., Dolmans M.M., Demylle D. et al. Live birth after orthotopic transplantion of cryopreserved ovarian tissue. Lanset 2000;364:1405—10.40. Parrot D.M.V. The fertility of mice with orthopic ovarian grafts derived from frozen tissue. J Reprod Fertil 1954;1:230—41.Parrot D.M.V. The fertility of mice with orthopic ovarian grafts derived from frozen tissue. J Reprod Fertil 1954;1:230—41.41. Gosden R.G., Baird D.T., Wade J.C. et al. Restoration of fertility to oophorectomized sheep by ovarian autografts stored at —196°C. Hum Reprod 1994;9;597—603.Gosden R.G., Baird D.T., Wade J.C. et al. Restoration of fertility to oophorectomized sheep by ovarian autografts stored at —196°C. Hum Reprod 1994;9;597—603.42. Hovatta O., Silye R., Krause T. et al. Cryopreservation of ovarian tissue using DMSO and propanediol-sucrose as cryoprotectans. Hum Reprod 1996;11:1268—72.Hovatta O., Silye R., Krause T. et al. Cryopreservation of ovarian tissue using DMSO and propanediol-sucrose as cryoprotectans. Hum Reprod 1996;11:1268—72.43. Oktay K., Newton H., Gosden R.C. Transplantation of cryopreserved human ovarian tissue results in follicle growth initiation in SCID mice. Fertil Steril 2000;73:599—603.Oktay K., Newton H., Gosden R.C. Transplantation of cryopreserved human ovarian tissue results in follicle growth initiation in SCID mice. Fertil Steril 2000;73:599—603.44. Oktay K., Bujuk E., Veeck L. et al. Embryo development after heterotopic transplantation of cryopreserved ovarian tissue. Lancet 2004;363:837—40.Oktay K., Bujuk E., Veeck L. et al. Embryo development after heterotopic transplantation of cryopreserved ovarian tissue. Lancet 2004;363:837—40.45. Kim S.S., Gosden R.G., Radford J.A. et al. A model to test the safety of human ovarian tissue transplantation after cryopreservation: xeno-grafts of ovarian tissues from cancer patients into NOD/LtSz-Scid mice. Program and Abstracts of the ASRM/CFAS Conjoint Annual Meeting, Toronto. Ontario, Canada, September 25—30, 1999. Fertil Steril 1999;72(Suppl):SI (abstr 003).Kim S.S., Gosden R.G., Radford J.A. et al. A model to test the safety of human ovarian tissue transplantation after cryopreservation: xeno-grafts of ovarian tissues from cancer patients into NOD/LtSz-Scid mice. Program and Abstracts of the ASRM/CFAS Conjoint Annual Meeting, Toronto. Ontario, Canada, September 25—30, 1999. Fertil Steril 1999;72(Suppl):SI (abstr 003).46. Meirow D., Epstein M., Lewis H. et al. Administration of cyclo-phosphamide at different stages of follicular maturation in mice: effects on reproductive performance and fetal malformations. Human Reprod 2001;16:632—7.Meirow D., Epstein M., Lewis H. et al. Administration of cyclo-phosphamide at different stages of follicular maturation in mice: effects on reproductive performance and fetal malformations. Human Reprod 2001;16:632—7.47. Игнашина Е.В., Пивник А.В., Шилин Д.Е. и др. Профилактика репродуктивных нарушений, возникающих в процессе химиотерапии у женщин детородного возраста, страдающих болезнью Ходжкина. Тер арх 1998;(7):49–53.Игнашина Е.В., Пивник А.В., Шилин Д.Е. и др. Профилактика репродуктивных нарушений, возникающих в процессе химиотерапии у женщин детородного возраста, страдающих болезнью Ходжкина. Тер арх 1998;(7):49–53.