Reproduction patterns among classical Hodgkin lymphoma survivors treated with BEACOPP and ABVD in Sweden, Denmark and Norway-A population-based matched cohort study.
Female
Child
Humans
Male
Hodgkin Disease
/ drug therapy
Doxorubicin
/ therapeutic use
Bleomycin
/ adverse effects
Sweden
/ epidemiology
Antineoplastic Combined Chemotherapy Protocols
/ therapeutic use
Cohort Studies
Vinblastine
/ therapeutic use
Dacarbazine
Vincristine
/ therapeutic use
Cyclophosphamide
/ therapeutic use
Etoposide
Reproduction
Prednisone
/ therapeutic use
Denmark
Hodgkin disease
chemotherapy
fertility
late effects of cancer treatment
survivorship
Journal
International journal of cancer
ISSN: 1097-0215
Titre abrégé: Int J Cancer
Pays: United States
ID NLM: 0042124
Informations de publication
Date de publication:
15 08 2023
15 08 2023
Historique:
received:
04
04
2023
accepted:
06
04
2023
medline:
21
6
2023
pubmed:
29
4
2023
entrez:
29
4
2023
Statut:
ppublish
Résumé
Childbirth rates in classical Hodgkin lymphoma (cHL) survivors have historically been reduced compared to the general population. Understanding if contemporary treatment protocols are associated with reduced fertility is crucial as treatment guidelines shift toward more liberal use of intensive chemotherapy. We identified 2834 individuals aged 18-40 years with cHL in Swedish and Danish lymphoma registers, and in the clinical database at Oslo University Hospital diagnosed 1995-2018, who were linked to national medical birth registers. Cox regression adjusted for stage, performance status, year, and age at diagnosis was used to estimate hazard ratios (HRs) and 95% confidence intervals (CI) contrasting time to first childbirth by treatment groups (ABVD, 2-4 BEACOPP, 6-8 BEACOPP) up to 10 years after diagnosis. Overall, 74.8% of patients were treated with ABVD, 3.1% with 2-4 BEACOPP and 11.2% with 6-8 BEACOPP. Adjusted HRs comparing childbirth rates in individuals treated with 6-8 BEACOPP, and 2-4 BEACOPP to ABVD were 0.53 (CI: 0.36-0.77) and 0.33 (CI: 0.12-0.91) for males, and 0.91 (CI: 0.61-1.34) and 0.38 (CI: 0.12-1.21) for females. Cumulative incidence of childbirths after 10 years was 19.8% (CI: 14.5%-27.0%) for males and 34.3% (CI: 25.8%-45.6%) for females treated with 6-8 BEACOPP. Proportions of children born after assisted reproductive technique (ART) treatments were 77.4% (CI: 60.2-88.6%) for males following 6-8 BEACOPP, and <11% for females. Among ABVD treated patients the corresponding proportions were 12.2% (CI: 8.5%-17.3%) and 10.6% (CI: 7.4%-14.9%). BEACOPP treatment is associated with decreased childbirth rates compared to ABVD in male, but not female, cHL patients, despite widespread access to ART in the Nordics.
Substances chimiques
Doxorubicin
80168379AG
Bleomycin
11056-06-7
Vinblastine
5V9KLZ54CY
Dacarbazine
7GR28W0FJI
Vincristine
5J49Q6B70F
Cyclophosphamide
8N3DW7272P
Etoposide
6PLQ3CP4P3
Prednisone
VB0R961HZT
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
723-731Informations de copyright
© 2023 The Authors. International Journal of Cancer published by John Wiley & Sons Ltd on behalf of UICC.
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