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13-11-2024 | mTOR-Inhibitors | Review

mTOR inhibitors potentially preserve fertility in female patients with haematopoietic malignancies: a narrative review

Authors: Yuji Tanaka, Tsukuru Amano, Akiko Nakamura, Mari Deguchi, Akimasa Takahashi, Shunichiro Tsuji, Takashi Murakami

Published in: Annals of Hematology | Issue 12/2024

Abstract

Haematologic malignancies are considered among the more common adolescent and young adult (AYA) cancers. Many female AYA patients with haematopoietic malignancies face impaired fertility. Haematologic malignancies patients tend to be treated with more aggressive systemic chemotherapy than that of solid tumours. In adult women, treatment-related contraception causes age-related fertility loss. Graft-versus-host disease (GVHD) after allogeneic haematopoietic stem cell transplantation is associated with decreased fertility. Ovarian cryopreservation is often indicated for haematopoietic malignancies; however, follicle loss associated with ovarian cryopreservation and ovarian minimal residual disease, which result in the withdrawal of the transplantation, are important issues. These problems may not be fully addressed by conventional methods of fertility preservation, such as oocyte, embryo, and ovarian cryopreservation, leaving room for research into new treatment approaches, such as fertility preservation drugs. In recent years, preclinical studies have shown that mTOR inhibitors may preserve chemotherapy-induced follicular loss, may have follicle-preserving effects on follicle loss associated with cryopreservation and transplantation of ovarian tissue, may have fertility-preserving effects on aging-related infertility. Clinical studies have shown that mTOR inhibitors may have the potential for indirect fertility preservation by controlling GVHD, have a limited anti-tumor effect against haematopoietic malignancies. The purpose of this article is to outline the various issues faced by female survivors of haematopoietic malignancies and discuss the potential of mTOR inhibitors as a safe treatment option. Based on current research, mTOR inhibitors seem promising and innovative fertility preservation agents regarding preclinical conditions, and further study, including clinical trials, should be expected.

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Title: mTOR inhibitors potentially preserve fertility in female patients with haematopoietic malignancies: a narrative review
Authors: Yuji Tanaka
Tsukuru Amano
Akiko Nakamura
Mari Deguchi
Akimasa Takahashi
Shunichiro Tsuji
Takashi Murakami
Publication date: 13-11-2024
Publisher: Springer Berlin Heidelberg
Keywords: mTOR-Inhibitors
Fertility
Infertility
Infertility
Graft-Versus-Host Disease
Graft-Versus-Host Disease
Alkylating Agent
Lymphoma
Published in: Annals of Hematology / Issue 12/2024
Print ISSN: 0939-5555
Electronic ISSN: 1432-0584
DOI: https://doi.org/10.1007/s00277-024-06090-3

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mTOR inhibitors potentially preserve fertility in female patients with haematopoietic malignancies: a narrative review

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