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Review
. 2018 Jun 13:10:1517-1526.
doi: 10.2147/CMAR.S154819. eCollection 2018.

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

Alexandra Traila #  1   2 , Delia Dima  3 , Patriciu Achimas-Cadariu #  1   2 , Romeo Micu  1   4
Affiliations
Review

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

Alexandra Traila et al. Cancer Manag Res. .

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; fertility preservation; infertility; pregnancy.

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Conflict of interest statement

Disclosure The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Algorithm for fertility preservation in HL patients, at diagnosis. Abbreviations: HL, Hodgkin’s lymphoma; ABVD, doxorubicine, bleomycin, vinblastine, dacarbazine; Esc BEACOPP, escalated bleomycine, etoposide, doxorubicine, cyclophosphamide, vincristine, procarbazine, prednisone; ART, assisted reproductive techniques.
Figure 2
Figure 2
Algorithm for fertility preservation in relapsed/refractory HL patients. Abbreviations: HL, Hodgkin’s lymphoma; ASCT, autologous stem cell transplantation.
See this image and copyright information in PMC

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