title: Prevalence of menstrual cycles and outcome of 50 pregnancies after high-dose chemotherapy and auto-SCT in non-Hodgkin and Hodgkin lymphoma patients younger than 40 years.
abstract: Data are limited regarding the prevalence of menstrual cycles and pregnancies after high-dose chemotherapy (HDC) and auto-stem cell transplantation (SCT). Female patients who underwent HDC auto-SCT for non-Hodgkin and Hodgkin lymphoma (1997-2012) were reviewed. The selection criteria were as follows: (1) alive without disease 12 and 24 months after auto-SCT for menstrual cycles and pregnancy, respectively, (2) age <40 years at auto-SCT, and (3) no primary infertility. One-hundred and seventy-six females underwent single auto-SCT. Eighty-nine were eligible for menstrual cycles and pregnancy analysis. Median age at auto-SCT was 25 years (14-40 years), at pregnancy 27 years (20-37 years), median follow-up 65 months (range 24-190). Regular menstrual-cycles resumed in 56/89 patients (63%). Increasing age (P=0.02) and number of prior chemotherapy cycles (P=0.02) are associated with higher risk of amenorrhea. Forty patients tried to get pregnant, 26 (65%) became pregnant 50 times: 43 (86%) live birth, 7 (14%) miscarriage and 2/50 had birth defects. Twenty-four patients practiced breastfeeding (median duration 4 months (1-24 months)). Enough breast milk production was reported 62.5% vs 100% in those patients who did or did not receive above the diaphragm radiation therapy, respectively, (P=0.066). Our data highlights significantly higher than perceived incidence of menstrual cycle resumption, successful pregnancies and breastfeeding after HDC auto-SCT.
authors.affiliation: Oncology Center, King Faisal Specialist Hospital & Research Center, Riyadh, Kingdom of Saudi Arabia.
authors.forename: S
authors.identifier: http://orcid.org/0000-0002-4294-0944
authors.initials: S
authors.lastname: Akhtar
authors.affiliation: Department of Nursing Affairs, King Faisal Specialist Hospital & Research Center, Riyadh, Kingdom of Saudi Arabia.
authors.forename: I
authors.initials: I
authors.lastname: Youssef
authors.affiliation: Oncology Center, King Faisal Specialist Hospital & Research Center, Riyadh, Kingdom of Saudi Arabia.
authors.forename: H
authors.initials: H
authors.lastname: Soudy
authors.affiliation: Oncology Center, King Faisal Specialist Hospital & Research Center, Riyadh, Kingdom of Saudi Arabia.
authors.forename: T A M
authors.initials: TA
authors.lastname: Elhassan
authors.affiliation: Oncology Center, King Faisal Specialist Hospital & Research Center, Riyadh, Kingdom of Saudi Arabia.
authors.forename: S M
authors.initials: SM
authors.lastname: Rauf
authors.affiliation: Oncology Center, King Faisal Specialist Hospital & Research Center, Riyadh, Kingdom of Saudi Arabia.
authors.forename: I
authors.initials: I
authors.lastname: Maghfoor
mesh_terms: D000328:Adult; D000568:Amenorrhea / Q000209:etiology / Q000628:therapy; D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D064592:Autografts; D005260:Female; D006689:Hodgkin Disease / Q000628:therapy*; D006801:Humans; D050498:Live Birth; D008228:Lymphoma, Non-Hodgkin / Q000628:therapy*; D008597:Menstrual Cycle; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000628:therapy*; D012189:Retrospective Studies; D033581:Stem Cell Transplantation
chemical_list: D000970:Antineoplastic Agents