As cure rates for young patients with Hodgkin lymphoma (HL) improve, the historically negative impact of treatments has to be considered. However, a new study has found that over time, childbearing rates for female survivors of HL have improved to the point of approaching the rates of the general population.
As cure rates for young patients with Hodgkin lymphoma (HL) improve, the historically negative impact of treatments has to be considered. A new study in Journal of Clinical Oncology analyzed childbearing and time to first childbirth after HL diagnosis in patients who only received first-line treatment.
The researchers used Swedish registers to study 449 women between the ages of 18 and 40 years who were diagnosed with HL between 1992 and 2009. The patients in the study were in remission 9 months after their diagnosis and they were age- and calendar-year—matched to 2210 comparators.
“Trends in childbearing over calendar time and treatments can provide caregivers with insight in how to counsel patients about their future fertility and family planning,” the authors wrote.
Among the patients with HL, 22.5% (101) had a childbirth during the follow-up period. Among the comparators, the childbirth rate was 28.9%. While the childbirth rate among patients with HL increased over time, as treatment according to the national guidelines changed, the rate for comparators remained stable. For patients with HL diagnosed in 2004-2009, childbirth rates were comparable to those of the comparators (69.7% vs 70.7%).
The researchers found that, regardless of stage and primary treatment, relapse-free female survivors of HL had birth rates similar to the general population from 3 years after diagnosis. Patients with high-risk disease who received the most gonadtoxic chemotherapy treatment had reduced childbirth rates for the first 3 years, but even their birth rates were similar to comparators after 3 years.
The study only included women who had not relapsed because the treatment after relapse is associated with a high infertility risk.
“In contrast, none of the women who experienced relapse had a childbirth after relapse, underlining the importance of curative first-line treatment also from a fertility perspective,” the authors noted.
Weibull CE, Johansson ALV, Eloranta S, et al. Contemporarily treated patients with Hodgkin lymphoma have childbearing potential in line with matched comparators [published online July 25, 2018]. J Clin Oncol. doi: 10.1200/JCO.2018.78.3514.