Treatment-related premature ovarian failure as a long-term complication after Hodgkin's lymphoma.
BACKGROUND
One of the medical sequelae that chemo- and radiotherapy may cause is premature ovarian failure (POF). The scope of this study was to investigate the risk of developing POF as a long-term complication in young women treated for Hodgkin's lymphoma.


METHODS
The 99 women included in the study were treated between 1975 and 1992 at the Norwegian Radium Hospital. All patients received radiotherapy and 67 of the women also received chemotherapy.


RESULTS
POF was found in 37.4% of the patients. The risk of developing POF was significantly higher if the patient received chemotherapy in addition to radiotherapy. Furthermore, the risk increased if chemotherapy included alkylating agents. Long-term follow-up revealed that women who at the time of treatment were under 30 years of age developed POF later, but with the same cumulative risk as women above 30 years of age.


CONCLUSIONS
The risk of developing POF after radio- and chemotherapy is higher than earlier estimates suggest. After an observation time of 15 years the cumulative risk is 38% independent of age at the time of treatment. Age below 30 years at the time of treatment delays the development of POF, but does not decrease the life-time risk.
Haukvik
U K H
UK
University of Oslo, Norway.
Dieset
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Bjøro
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Holte
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Fosså
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SD
D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D002648:Child; D003430:Cross-Sectional Studies; D015914:Estrogen Replacement Therapy / Q000706:statistics & numerical data; D004967:Estrogens / Q000172:deficiency; D005260:Female; D006689:Hodgkin Disease / Q000150:complications / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy*; D006801:Humans; D016649:Primary Ovarian Insufficiency / Q000209:etiology*; D011336:Probability; D011832:Radiation Injuries / Q000150:complications* / Q000453:epidemiology*; D011878:Radiotherapy / Q000009:adverse effects; D012307:Risk Factors; D013995:Time
D004967:Estrogens