Fertility preservation in Hodgkin’s lymphoma patients that undergo targeted molecular therapies: an important step forward from the chemotherapy era

• Main Authors: Traila A, Dima D, Achimas-Cadariu P, Micu R
• Format: Article
• Language: English
• Published: Dove Medical Press 2018-06-01
• Series: Cancer Management and Research
• Subjects: Hodgkin's lymphoma; infertility; pregnancy; fertility preservation
• Online Access: https://www.dovepress.com/fertility-preservation-in-hodgkins-lymphoma-patients-that-undergo-targ-peer-reviewed-article-CMAR

Alexandra Traila,1,2,* Delia Dima,3 Patriciu Achimas-Cadariu,1,2,* Romeo Micu1,4 1School of Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj Napoca, Romania; 2Department of Surgical Oncology, Ion Chiricuta Oncology Institute, Cluj Napoca, Romania; 3Department of Hematology, Ion Chiricuta Oncology Institute, Cluj Napoca, Romania; 4Department of Human Assisted Reproduction of 1st Gynecology Clinic, Cluj Napoca, Romania *These authors contributed equally to this work Abstract: 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. Keywords: Hodgkin’s lymphoma, infertility, pregnancy, fertility preservation