Gonadal Function Recovery and Fertility in Women Treated with Chemo- and/or Radiotherapy for Hodgkin's and Non-Hodgkin Lymphoma.

Abstract

BACKGROUND:

Fertility and gonadal function represent one of the most important aspects for long-term lymphoma survivors.

AIMS:

The aim of our study was to determine possible risk factors, such as age at treatment, chemotherapeutic regimen, protection with oral contraceptives (OCs), and gonadotropin-releasing hormone (GnRH) analogues in female patients treated for Hodgkin's lymphoma (HL) or non-Hodgkin lymphoma (NHL) at a reproductive age.

METHODS:

Patients between the age of 16 and 50 years at the time of HL or NHL diagnosis were selected. Eligible patients were requested to respond to a questionnaire by phone interview about fertility, menstrual status, sexual aspects, and treatment with OCs or GnRH analogues during chemotherapy.

RESULTS:

The resumption of menstrual activity was associated with the use of the OCs and GnRH analogues during chemotherapy (p = 0.008 and 0.034, respectively). At univariate analysis, the use of OCs during chemotherapy was associated with a lower risk of amenorrhea (prevalence ratio [PR] = 0.37; 95% CI 0.17-0.82). A higher age at the time of treatment correlated positively with therapy-induced amenorrhea, with a difference of 12.8 years between the mean age at diagnosis of the women with therapy-induced amenorrhea and those who resumed their menses. Amenorrhea was significantly higher in women receiving R-CHOP than in women treated with ABVD (PR = 6.00; 95% CI 2.32-15.54). Moreover, NHL had an infertility PR of 1.51 (95% CI 0.86-2.45) at multivariate analysis compared to HL.

CONCLUSIONS:

This study suggests a possible role of pharmacological prophylaxis with OCs and GnRH analogues.

• Authors: Guido Gini, Ombretta Annibali, Diana Lupasco, Caterina Bocci, Valeria Tomarchio, Michela Sampaolo, Silvia Trappolini, Maria Antonietta Tafuri, Sonia Cacciagiù, Mariavita Ciccarone, Alessandra Barucca, Chiara Sarlo, Bruno Vincenzi, Giuseppe Avvisati, Pietro Leoni, Attilio Olivieri
• Journal: Chemotherapy (Chemotherapy) Vol. 64 Issue 1 Pg. 36-41 ( 2019) ISSN: 1421-9794 [Electronic] Switzerland
• PMID: 31117081 (Publication Type: Journal Article)
• Copyright: © 2019 S. Karger AG, Basel.

Chemical References

• Contraceptive Agents
• Gonadotropin-Releasing Hormone

Topics

• Administration, Oral
• Adolescent
• Adult
• Amenorrhea (drug therapy, etiology)
• Antineoplastic Combined Chemotherapy Protocols (adverse effects, therapeutic use)
• Contraceptive Agents (pharmacology, therapeutic use)
• Female
• Fertility (drug effects)
• Gonadotropin-Releasing Hormone (pharmacology, therapeutic use)
• Hodgkin Disease (drug therapy, radiotherapy, therapy)
• Humans
• Lymphoma, Non-Hodgkin (drug therapy, radiotherapy, therapy)
• Middle Aged
• Recovery of Function
• Young Adult