title: Risk factors for impaired gonadal function in female Hodgkin lymphoma survivors: final analysis of a retrospective multicenter joint study from Italian and Brazilian Institutions.
abstract: Hodgkin lymphoma (HL) is one of the most common types of cancer in the young and one of the most curable forms of cancer. Therefore, there has been an increasing interest in the study of long-term morbidities. The aims of the present study were to evaluate the prevalence and risk factors for impaired gonadal function in a retrospective cohort of 238 HL female survivors from Italy and Brazil and to analyse the role of oral contraceptives (OC) and GnRH-analogues. Besides data collection from HL databases, a specific questionnaire was administered to collect data on gonadal function. The median age at diagnosis was 25 years and the median follow-up was 7 years. Overall, 25% of the patients developed impaired gonadal function. Older age at diagnosis, front-line therapies containing alkylating agents and more than one treatment were independent risk factors, whereas the use of OC or GnRH-a reduced independently the risk of impaired gonadal function. The fertility rate among fertile survivors was low when compared with the general population. We confirmed that older age, type of front-line chemotherapy and a higher number of therapies are associated with gonadal function impairment in terms of infertility and premature menopause in female HL survivors. Also, the use of GnRH-a or OC was independently identified as a protective factor. Further prospective studies are needed to better understand the barriers to parenthood in HL survivors.
authors.affiliation: Dipartimento di Ematologia, Ospedale Civile Spirito Santo, Pescara, Italy.
authors.forename: Simona
authors.initials: S
authors.lastname: Falorio
authors.forename: Irene
authors.initials: I
authors.lastname: Biasoli
authors.forename: Stefano
authors.initials: S
authors.lastname: Luminari
authors.forename: Giovanni
authors.initials: G
authors.lastname: Quintana
authors.forename: Maurizio
authors.initials: M
authors.lastname: Musso
authors.forename: Matteo
authors.initials: M
authors.lastname: Dell'olio
authors.forename: Maria Rosaria
authors.initials: MR
authors.lastname: Specchia
authors.forename: Nicola
authors.initials: N
authors.lastname: di Renzo
authors.forename: Marina
authors.initials: M
authors.lastname: Cesaretti
authors.forename: Gabriele
authors.initials: G
authors.lastname: Buda
authors.forename: Daniele
authors.initials: D
authors.lastname: Vallisa
authors.forename: Donato
authors.initials: D
authors.lastname: Mannina
authors.forename: Alessandro
authors.initials: A
authors.lastname: Andriani
authors.forename: Carlos Sérgio
authors.initials: CS
authors.lastname: Chiattone
authors.forename: Márcia Torresan
authors.initials: MT
authors.lastname: Delamain
authors.forename: Cármino A
authors.initials: CA
authors.lastname: de Souza
authors.forename: Nelson
authors.initials: N
authors.lastname: Spector
authors.forename: Francesco
authors.initials: F
authors.lastname: Angrilli
authors.forename: Massimo
authors.initials: M
authors.lastname: Federico
mesh_terms: D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001938:Brazil; D003276:Contraceptives, Oral; D005260:Female; D059247:Fertility Preservation; D006689:Hodgkin Disease / Q000503:physiopathology* / Q000628:therapy; D006801:Humans; D007246:Infertility / Q000209:etiology*; D007558:Italy; D010053:Ovary / Q000503:physiopathology*; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis; D055815:Young Adult
chemical_list: D003276:Contraceptives, Oral