nodgoРоссийский журнал детской гематологии и онкологии (РЖДГиО)Russian Journal of Pediatric Hematology and Oncology2311-12672413-5496LTD “Graphica”10.21682/2311-1267-2019-6-3-59-67nodgo-527Research ArticleОБЗОРЫ ЛИТЕРАТУРЫLITERATURE REVIEWSКриоконсервация ткани яичника у девочек с онкологической патологией: мультидисциплинарная программаCryopreservation of ovarian tissue in girls with oncological diseases: a multidisciplinary approachhttps://orcid.org/0000-0002-2003-0982ДиникинаЮ. В.DinikinaYu. V.

Юлия Валерьевна Диникина

к.м.н., заведующая отделением химиотерапии онкогематологических заболеваний и трансплантации костного мозга для детей

197341, Санкт-Петербург, ул. Аккуратова

Yu.V. Dinikina: Cand. of Sci. (Med.), Head of the Department of Chemotherapy for Hematologic Diseases and Bone Marrow Transplantation

2 Akkuratova St., S.-Petersburg, 197341

dinikinayulia@mail.ruhttps://orcid.org/0000-0002-7471-7181БелогуроваМ. Б.BelogurovaM. B.

д.м.н., профессор, ведущий научный сотрудник института гематологии

197341, Санкт-Петербург, ул. Аккуратова

Dr. of Sci. (Med.), Professor, Leading Scientific Collaborator of Institution of Hematology

2 Akkuratova St., S.-Petersburg, 197341

deton.hospital31@inbox.ruhttps://orcid.org/0000-0003-1809-0270ГоворовИ. Е.GovorovI. E.

младший научный сотрудник научно-исследовательской лаборатории оперативной гинекологии

197341, Санкт-Петербург, ул. Аккуратова, 2

Junior Researcher Laboratory of Operative Gynecology

2 Akkuratova St., S.-Petersburg, 197341

govorov_ie@almazovcentre.ruГамзатоваЗ. Х.GamzatovaZ. Kh.

к.м.н., врач-акушер-гинеколог

197341, Санкт-Петербург, ул. Аккуратова, 2

Cand. of Sci. (Med.), Obstetrician-Gynecologist

2 Akkuratova St., S.-Petersburg, 197341

zainab2@yandex.ruПервунинаТ. М.PervuninaT. M.

к.м.н., директор

197341, Санкт-Петербург, ул. Аккуратова, 2

Cand. of Sci. (Med.), Head

2 Akkuratova St., S.-Petersburg, 197341

pervunina_tm@almazovcentre.ruhttps://orcid.org/0000-0003-2943-0883КомличенкоЭ. В.KomlichenkoE. V.

д.м.н., заместитель директора по научно-лечебной работе

197341, Санкт-Петербург, ул. Аккуратова, 2

Dr. of Sci. (Med.), Deputy Director for Scientific and Medical Work

2 Akkuratova St., S.-Petersburg, 197341

Komlichenko_ev@almazovcentre.ruОтделение химиотерапии онкогематологических заболеваний и трансплантации костного мозга для детей ФГБУ «Национальный медицинский исследовательский центр им. В.А. Алмазова» Минздрава РоссииРоссияChildren Almazov National Medical Research Center, Ministry of Health of RussiaRussian FederationИнститут перинатологии и педиатрии ФГБУ «НМИЦ им. В.А. Алмазова» Минздрава РоссииРоссияInstitute of Perinatology and Pediatrics Almazov National Medical Research Center, Ministry of Health of RussiaRussian Federation201924092019635967Copyright © Диникина Ю.В., Белогурова М.Б., Говоров И.Е., Гамзатова З.Х., Первунина Т.М., Комличенко Э.В., 20192019Диникина Ю.В., Белогурова М.Б., Говоров И.Е., Гамзатова З.Х., Первунина Т.М., Комличенко Э.В.Dinikina Y.V., Belogurova M.B., Govorov I.E., Gamzatova Z.K., Pervunina T.M., Komlichenko E.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.nodgo.org/jour/article/view/527

С улучшением показателей выживаемости детей с онкологическими заболеваниями вопросы полноценного качества жизни приобретают все большее значение. Возможность минимизации токсичности противоопухолевой терапии со стороны различных органов и систем без снижения эффективности специфической терапии, а также разработка мер профилактики сегодня являются важной задачей врачей-специалистов. Гонадотоксичность – частое неблагоприятное событие, оказывающее негативное влияние как на соматический, так и психоэмоциональный статус излеченных пациенток. В когорте девочек препубертатного возраста с высоким риском преждевременного истощения яичников на сегодняшний день единственной перспективой сохранения репродуктивной функции является криоконсервация ткани яичника. Основная цель публикации – подчеркнуть значимость проблемы репродуктивного здоровья девочек с онкологическими заболеваниями, с описанием современных данных международной литературы по перспективам метода криоконсервации овариальной ткани в целях сохранения фертильности. Представить мультидисциплинарную стратегию ведения пациенток препубертатного возраста с онкологическим заболеванием в рамках проекта онкофертильности в ФГБУ «НМИЦ им. В.А. Алмазова». На основании данных российской и международной литературы, существующих руководств и рекомендаций по сохранению репродуктивного здоровья разработан единый алгоритм отбора пациенток с учетом ожидаемой гонадотоксичности для использования метода криоконсервации ткани яичника у девочек препубертатного возраста. Проведение всех этапов возможно в оптимальные сроки противоопухолевой терапии в условиях одного стационара с соблюдением этапности оказания медицинской помощи. Разработанный алгоритм позволит активно выявлять пациенток препубертатного возраста, требующих использования современных возможностей репродуктивных технологий. В отдаленные сроки планируется оценить эффективность методики ортотопической реимплантации криоконсервированной ткани яичника для реализации репродуктивной функции. Мультидисциплинарная команда специалистов и условия федерального центра на сегодняшний день в полном объеме позволяют внедрить программу «онкофертильности» в ежедневную практику при оказании помощи онкологическим пациенткам.

The issues concerning quality of life are becoming increasingly important with the improvement of survival rates in children with cancer. The possibility of minimizing the toxicity of antitumor therapy for various organs and systems without reducing the effectiveness of specific therapy, as well as the development of preventive measures, is now an important task of medical specialists. Gonadal toxicity is a frequent adverse event that negatively affects both the somatic and psychological and emotional state of the cured patients. The only prospect of reproductive function preserving in a cohort of prepubertal girls with a high risk of premature ovarian failure is the ovarian tissue cryopreservation. The main goal of this publication is to emphasize the importance of the reproductive health problem of girls with oncological diseases, with a description of the current data of international literature on the prospects of ovarian tissue cryopreservation in order to preserve fertility. Another goal is to present a multidisciplinary strategy for the management of prepubertal age patients with oncological disease within the framework of the Oncological Fertility Project at Almazov National Medical Research Center. Based on the data of Russian and international literature, as well as existing guidelines and recommendations on reproductive health, a single algorithm for selecting patients has been developed, considering the expected gonadal toxicity for the use of the ovarian cryopreservation method in prepubertal girls. Carrying out of all the steps is possible in the optimal terms of antitumor therapy in the conditions of one hospital with observance of the stages of medical aid provision. The developed algorithm will allow to identify patients of prepubertal age, requiring the use of modern possibilities of reproductive technologies. In long-term date we are planning to evaluate the effectiveness of the orthotopic reimplantation technique for cryopreserved ovarian tissue in order to realize the reproductive function. A multidisciplinary team of specialists and the possibilities of the federal center fully allow to realize the Oncofertility Program in daily practice for girls and young women who needs to undertake gonadotoxic treatment.

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The authors declare that there are no conflicts of interest present.