Post-treatment parenthood in Hodgkin's lymphoma survivors

Abstract

Attempted and achieved post-treatment parenthood, with or without use of assisted reproduction techniques (ARTs), was assessed in Hodgkin's lymphoma survivors treated from 1971 -1998, aged below 50 (females) or 65 (males) at diagnosis, aged 18 to 75 at survey. Four treatment groups were constructed: radiotherapy only, low -, medium -and high gonadotoxic chemotherapy (with or without radiotherapy in the three chemotherapy groups). Using Kaplan -Meier estimates, log-rank tests and Cox regression analyses, factors influencing post-treatment parenthood were investigated, with birth of the first child after treatment as the end point. Fortyfive per cent (120/269) of males and 50% (91/184) of females reported attempted post-treatment parenthood. Of these, 76 (63%) males and 68 (75%) females had a child without use of ARTs. In addition 10 males and one female achieved post-treatment parenthood with use of ARTs. Treatment group was significantly associated with post-treatment parenthood, with highest probabilities after radiotherapy only and low gonadotoxic chemotherapy. In univariate analyses, age at diagnosis was a significant factor related to post-treatment parenthood in females.

Gonadal function and parenthood 20 years after treatment for childhood lymphoma: A cross‐sectional study

“…The high success rate of maternity in our survey emerged among women who had tried to become mothers. The result is in concordance with a similar study in adults [28]. If all surveyed women were considered, the comparable rate is expected to be more in agreement with published figures [29], but still higher in females than in males (63% vs. 24%, P ¼ 0.04), this indicating higher gonadotoxicity in men than in women receiving the same treatments.…”

Gonadal function in male patients after treatment for malignant lymphomas, with emphasis on chemotherapy

“…We confirm the results from our previous study in HLSs, where we observed exocrine gonadal damage related to the type, cumulative dose and intensity of chemotherapy, assessed by post-treatment paternity (Kiserud et al, 2007). This study shows for the first time that the same categorization of chemotherapy in low, medium and highly gonadotoxic treatment can be useful also when exploring endocrine hypogonadism.…”

“…Treatment strategies of HL and NHL at the NRH for the period 1980 -2002 have been described earlier (Hagemeister et al, 1987;Merk et al, 1991;Evensen et al, 1994;Abrahamsen et al, 1996;Holte et al, 1996;Hollender et al, 2000;Aurlien et al, 2001;Seidemann et al, 2001;Sweetenham et al, 2001;Blystad et al, 2001aBlystad et al, , 2001bSmeland et al, 2004;Kiserud et al, 2007).…”

“…As there is little knowledge concerning damage of the Leydig cell function by chemotherapy, we have categorised chemotherapy according to the expected exocrine gonadal damage. Categories were created based mainly on literature on post-treatment exocrine hypogonadism, as reported in a previous study on post-treatment parenthood in HLSs: low, medium and high chemotherapy-induced gonadotoxicity (Viviani et al, 1985;Howell and Shalet, 2001;Lee et al, 2006;Kiserud et al, 2007). In addition, a group was constructed including patients who had received radiotherapy only.…”

Reproductive function in women after radio- and chemoradiotherapy of Hodgkin's lymphoma and health status of born children.

“…По данным C. E. Kiserud с соавт., 2007, лишь около 20 % женщин, получивших лечение по поводу ЛХ, рожают впоследствии детей [39]. Помимо естественных причин (возраст, нали-чие детей до лечения ЛХ), существенную роль в этом играет как утрата фертильности вслед-ствие лечения ЛХ, так и ряд социальных и пси- Как показано ранее, большинство случаев прогрессирования и рецидивов ЛХ после тера-пии первой линии развивается в первые 2 года по завершении лечения [1,12].…”