Ontology type: schema:ScholarlyArticle
2002-09
AUTHORS ABSTRACTLe pronostic des cancers de l’homme jeune en âge de procréer s’est considérablement amélioré ces dernières décades grâce aux progrès thérapeutiques. Les chimiothérapies et radiothérapies ont des effets bien connus sur la spermatogenèse. Au dela de l’atteinte quantative et qualitative de la spermatogenèse, des études réalisées chez l’animal ont pu mettre en évidence des atteintes nucléaires (aneuploïdie, présence d’adduits, fragmentation de l’ADN…) et parfois des atteintes au niveau des générations F1 et F2. Chez l’homme, l’étude des chromosomes des spermatozoïdes après radiothérapie a mis en évidence une augmentation de la fréquence des anomalies chromosomiques. Concernant la chimiothérapie, les premières études utilisaient la technique de fécondation hétérospécifique pour mettre en évidence les anomalies chromosomiques du spermatozoïde. Plus récemment, la technique d’hybridation de sondes chromosomiques fluorescentes (FISH) permet d’étudier plusieurs chromosomes sur un grand nombre de spermatozoides. Les résultats des différentes études portant sur des effectifs réduits sont variables en fonction du protocole thérapeutique administré et de la durée séparant le prélèvement de la fin du traitement. Nous avons étudié 5 patients ayant fait un prélèvement de sperme 6 à 17 mois après le protocole de chimiothérapie BEP (Bléomycin, Etoposide, Cisplatin). Nous avons mis en évidence une augmentation du taux de spermatozoïdes présentant une aneuploïdie et une diploïdie. Les résultats de notre étude et de celles du groupe de R. Martin [45, 47] évoquent la possibilité d’un effet transitoire de la chimiothérapie sur les chromosomes gamétiques. Dans le cadre de la maladie de Hodgkin d’autres études ont mis en évidence l’aspect transitoire de l’effet sur l’aneuploïdie. Au dela de l’atteinte chromosomique, l’action délétère des traitements pourrait avoir pour cible l’ADN du spermatozoïde. Ainsi des études sur des effectifs importants, utilisant d’autres métodes d’analyse nous parraissent nécessaires. Dans l’attente, il paraît souhaitable de toujours conseiller l’autoconservation de sperme avant les traitements et d’adopter une grande prudence lors du conseil apporté aux patients désirant une grossesse, précocément, après la fin des traitements. More... »
PAGES284-294
http://scigraph.springernature.com/pub.10.1007/bf03035141
DOIhttp://dx.doi.org/10.1007/bf03035141
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"description": "Le pronostic des cancers de l\u2019homme jeune en \u00e2ge de procr\u00e9er s\u2019est consid\u00e9rablement am\u00e9lior\u00e9 ces derni\u00e8res d\u00e9cades gr\u00e2ce aux progr\u00e8s th\u00e9rapeutiques. Les chimioth\u00e9rapies et radioth\u00e9rapies ont des effets bien connus sur la spermatogen\u00e8se. Au dela de l\u2019atteinte quantative et qualitative de la spermatogen\u00e8se, des \u00e9tudes r\u00e9alis\u00e9es chez l\u2019animal ont pu mettre en \u00e9vidence des atteintes nucl\u00e9aires (aneuplo\u00efdie, pr\u00e9sence d\u2019adduits, fragmentation de l\u2019ADN\u2026) et parfois des atteintes au niveau des g\u00e9n\u00e9rations F1 et F2. Chez l\u2019homme, l\u2019\u00e9tude des chromosomes des spermatozo\u00efdes apr\u00e8s radioth\u00e9rapie a mis en \u00e9vidence une augmentation de la fr\u00e9quence des anomalies chromosomiques. Concernant la chimioth\u00e9rapie, les premi\u00e8res \u00e9tudes utilisaient la technique de f\u00e9condation h\u00e9t\u00e9rosp\u00e9cifique pour mettre en \u00e9vidence les anomalies chromosomiques du spermatozo\u00efde. Plus r\u00e9cemment, la technique d\u2019hybridation de sondes chromosomiques fluorescentes (FISH) permet d\u2019\u00e9tudier plusieurs chromosomes sur un grand nombre de spermatozoides. Les r\u00e9sultats des diff\u00e9rentes \u00e9tudes portant sur des effectifs r\u00e9duits sont variables en fonction du protocole th\u00e9rapeutique administr\u00e9 et de la dur\u00e9e s\u00e9parant le pr\u00e9l\u00e8vement de la fin du traitement. Nous avons \u00e9tudi\u00e9 5 patients ayant fait un pr\u00e9l\u00e8vement de sperme 6 \u00e0 17 mois apr\u00e8s le protocole de chimioth\u00e9rapie BEP (Bl\u00e9omycin, Etoposide, Cisplatin). Nous avons mis en \u00e9vidence une augmentation du taux de spermatozo\u00efdes pr\u00e9sentant une aneuplo\u00efdie et une diplo\u00efdie. Les r\u00e9sultats de notre \u00e9tude et de celles du groupe de R. Martin [45, 47] \u00e9voquent la possibilit\u00e9 d\u2019un effet transitoire de la chimioth\u00e9rapie sur les chromosomes gam\u00e9tiques. Dans le cadre de la maladie de Hodgkin d\u2019autres \u00e9tudes ont mis en \u00e9vidence l\u2019aspect transitoire de l\u2019effet sur l\u2019aneuplo\u00efdie. Au dela de l\u2019atteinte chromosomique, l\u2019action d\u00e9l\u00e9t\u00e8re des traitements pourrait avoir pour cible l\u2019ADN du spermatozo\u00efde. Ainsi des \u00e9tudes sur des effectifs importants, utilisant d\u2019autres m\u00e9todes d\u2019analyse nous parraissent n\u00e9cessaires. Dans l\u2019attente, il para\u00eet souhaitable de toujours conseiller l\u2019autoconservation de sperme avant les traitements et d\u2019adopter une grande prudence lors du conseil apport\u00e9 aux patients d\u00e9sirant une grossesse, pr\u00e9coc\u00e9ment, apr\u00e8s la fin des traitements.",
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"name": "G\u00e9notoxicit\u00e9 des chimioth\u00e9rapies et radioth\u00e9rapies: Quelles sont les cons\u00e9quences pour le spermatozo\u00efde humain?",
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