Risk of Premature Menopause After Treatment for Hodgkin’s Lymphoma
Menée au Royaume-Uni auprès de 2 127 patientes atteintes d'un lymphome hodgkinien avant l'âge de 36 ans et suivies sur la période 2003-2012, cette étude analyse l'association entre les traitements anticancéreux et le risque de ménopause précoce
Gonadal toxicity from chemotherapy and radiotherapy in patients with cancer is a well-recognized complication of treatment. The germinal epithelium of the testis may be more sensitive in this regard than the corresponding tissue in the ovary, reflecting the fact that continuing gametogenesis is limited to the male gonad. As a corollary, the risk of premature andropause is less than that of premature menopause because of the relative resistance of the Leydig cells in the testis to radiation and radiomimetic chemotherapy, exemplified by the use of alkylating agents such as cyclophosphamide. Consequently, while men are more likely to experience loss of fertility with the same exposure to antineoplastic therapy, women face the added burden of estrogen deprivation with its attendant morbidities.
Oncofertility, a term coined less than a decade ago by Dr. Teresa Woodruff (1), has become a “hot button” issue for young people with cancer (2), but for women premature ovarian failure carries health hazards that extend beyond the end of the reproductive period (3). As a result, the findings reported by Prof. Swerdlow and colleagues in young .....
Journal of the National Cancer Institute , éditorial, 2014