Impact of haematopoietic stem cell transplantation for benign and malignant haematologic and non-haematologic disorders on fertility: a systematic review and meta-analysis

IF 4.5 2区医学 Q1 HEMATOLOGY

Bone Marrow Transplantation Pub Date : 2025-02-26 DOI:10.1038/s41409-025-02520-6

Angela Vidal, Cristina Bora, Andrea Jarisch, Janna Pape, Susanna Weidlinger, Tanya Karrer, Michael von Wolff

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Abstract

Haematopoietic stem cell transplantation (HSCT) exposes patients to long-term complications like gonadal dysfunction and infertility. The European Society for Blood and Marrow Transplantation advised in 2015 that fertility preservation should be considered for children and adolescents requiring HSCT. This systematic review and meta-analysis is part of the FertiTOX project, which aims to close the data gap regarding the gonadotoxicity of anticancer therapies to provide more accurate advice regarding fertility preservation. This review were conducted in November 2023, covering articles since 2000. In total, 56 studies were included in the meta-analysis, comprising 1853 female malignant, 241 female benign, 1871 male malignant, and 226 male benign cases. The analysis, using a random-effects model, estimated the prevalence and its 95% confidence interval, revealing that overall infertility exceeded 30% in all groups. Female malignant cases had a prevalence of 65% (95% CI: 0.58–0.71), while in females with benign disease, it was 61% (CI: 0.48–0.73). Males with malignant disease had a prevalence of 41% (CI: 0.32–0.51), and those with benign disease had 31% (CI: 0.19–0.46). The > 30% overall prevalence indicates a clinical need for fertility preservation counseling in both genders undergoing HSCT. Further prospective studies are necessary to address HSCT’s individual impact on gonadal function. This systematic review is registered with the International Prospective Register of Systematic Reviews (PROSPERO) under CRD42023486928.

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造血干细胞移植治疗良性和恶性血液病和非血液病对生育的影响：系统回顾和荟萃分析。

造血干细胞移植（HSCT）使患者面临性腺功能障碍和不孕等长期并发症。欧洲血液和骨髓移植协会在2015年建议，对于需要造血干细胞移植的儿童和青少年，应该考虑保留生育能力。该系统综述和荟萃分析是FertiTOX项目的一部分，旨在缩小关于抗癌治疗的性腺毒性的数据差距，为生育能力的保存提供更准确的建议。本次审查于2023年11月进行，涵盖了自2000年以来的文章。meta分析共纳入56项研究，其中女性恶性1853例，女性良性241例，男性恶性1871例，男性良性226例。该分析使用随机效应模型，估计了患病率及其95%置信区间，显示所有组的总体不孕症超过30%。女性恶性病例的患病率为65% (95% CI: 0.58-0.71)，而女性良性疾病的患病率为61% （CI: 0.48-0.73）。男性恶性疾病患病率为41% (CI: 0.32-0.51)，良性疾病患病率为31% （CI: 0.19-0.46）。30%的总体患病率表明，在接受HSCT的男女患者中，临床都需要进行生育保留咨询。进一步的前瞻性研究是必要的，以解决HSCT对性腺功能的个体影响。本系统评价已在国际前瞻性系统评价注册中心（PROSPERO）注册，编号为CRD42023486928。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Bone Marrow Transplantation 医学-免疫学

CiteScore

8.40

自引率

8.30%

发文量

337

审稿时长

6 months

期刊介绍： Bone Marrow Transplantation publishes high quality, peer reviewed original research that addresses all aspects of basic biology and clinical use of haemopoietic stem cell transplantation. The broad scope of the journal thus encompasses topics such as stem cell biology, e.g., kinetics and cytokine control, transplantation immunology e.g., HLA and matching techniques, translational research, and clinical results of specific transplant protocols. Bone Marrow Transplantation publishes 24 issues a year.