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

• Published in: Chemotherapy (Basel) p. 1
• Main Authors: Gini, Guido, Annibali, Ombretta, Lupasco, Diana, Bocci, Caterina, Tomarchio, Valeria, Sampaolo, Michela, Trappolini, Silvia, Tafuri, Maria Antonietta, Cacciagiù, Sonia, Ciccarone, Mariavita, Barucca, Alessandra, Sarlo, Chiara, Vincenzi, Bruno, Avvisati, Giuseppe, Leoni, Pietro, Olivieri, Attilio
• Format: Journal Article
• Language: English
• Published: Switzerland 01.01.2019
• Subjects: Chemotherapy; GnRH analogues; Fertility; Lymphoma
• ISSN: 1421-9794
• DOI: 10.1159/000499535

Fertility and gonadal function represent one of the most important aspects for long-term lymphoma survivors. 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. 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. 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. This study suggests a possible role of pharmacological prophylaxis with OCs and GnRH analogues.