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Cancers dans l'enfance et fertilité à l'âge adulte

Abstract : Advances in the treatment of childhood and adolescent cancers have led to real improvements as long-term survival is now over 80%. As a result, quality of life of these future adults is a major concern for the professionals involved in the care of these patients. Our work focuses on pubertal development and fertility, through epidemiological research and transfer research, in childhood cancer survivor.Concerning the "epidemiological research", female pubertal development and fertility were studied using the L.E.A cohort (Childhood and Adolescent Leukemias), which collects data about the outcome of patients treated for childhood leukemia. Although it is more important in women who received hematopoietic stem cell transplantation and/or relapsed, gonadotoxicity also affects those who received only first-line chemotherapy.In parallel, access to fertility preservation for adolescents and young adults treated for malignant diseases in Auvergne was analyzed. Boys benefit more from fertility consultation and preservation of their fertility. Progress should be made thanks the creation of clinico-biological platforms such as PREFERA (PREservation FERtilité Auvergne), which ensure better coordination between the different teams that support these patients.Concerning the "transfer research", we addressed the cryopreservation of gonadal tissues, only option for prepubertal children in particular, but with a potential risk of neoplastic cells reintroduction in case of future use. We developed sensitive and specific techniques of residual disease detection for two solid pediatric tumors whose current treatments are potentially sterilizing: neuroblastoma and Ewing's tumor. The interest is to have a diagnostic test usable for adults cured of these cancers, whose fertility has been compromised by the treatments and who have benefited from ovarian or testicular tissue cryopreservation.
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Victoria Grèze. Cancers dans l'enfance et fertilité à l'âge adulte. Cancer. Université Clermont Auvergne, 2019. Français. ⟨NNT : 2019CLFAS011⟩. ⟨tel-02498236⟩

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