title: Female fertility following dose-adjusted EPOCH-R chemotherapy in primary mediastinal B-cell lymphomas.
abstract: We assessed fertility/gonadal function in premenopausal women treated with dose-adjusted EPOCH-Rituximab for untreated primary mediastinal B-cell lymphoma (PMBL). Eligible patents were ≤ 50 years and premenopausal. Serial reproductive histories were obtained and hormonal assays were performed on serum samples before, at the end of treatment and 4-18 months later. Twenty-eight eligible women had a median age (range) of 31 (21-50) years and were followed a median of 7.3 years. Of 23 patients who completed a questionnaire, 19 (83%) were and four were not menstruating prior to chemotherapy. Amenorrhea developed in 12 patients during chemotherapy. At > 1-year follow-up, 14/19 (74%) patients were menstruating, all < 35 years old, and six (43%) of these patients delivered healthy children. Hormonal assays showed ovarian dysfunction during chemotherapy in all patients with varying recovery at 4-18 months after treatment. Fertility was preserved in most women with ovarian failure confined to patients > 40 years old.
authors.affiliation: a Lymphoid Malignancy Branch, Center for Cancer Research , National Cancer Institute , Bethesda , MD , USA ;
authors.forename: Helen
authors.initials: H
authors.lastname: Gharwan
authors.affiliation: a Lymphoid Malignancy Branch, Center for Cancer Research , National Cancer Institute , Bethesda , MD , USA ;
authors.forename: Catherine
authors.initials: C
authors.lastname: Lai
authors.affiliation: a Lymphoid Malignancy Branch, Center for Cancer Research , National Cancer Institute , Bethesda , MD , USA ;
authors.forename: Cliona
authors.initials: C
authors.lastname: Grant
authors.affiliation: a Lymphoid Malignancy Branch, Center for Cancer Research , National Cancer Institute , Bethesda , MD , USA ;
authors.forename: Kieron
authors.initials: K
authors.lastname: Dunleavy
authors.affiliation: b Biostatistics and Data Management Section Center for Cancer Research , National Cancer Institute , Bethesda , MD , USA ;
authors.forename: Seth M
authors.initials: SM
authors.lastname: Steinberg
authors.affiliation: a Lymphoid Malignancy Branch, Center for Cancer Research , National Cancer Institute , Bethesda , MD , USA ;
authors.forename: Margaret
authors.initials: M
authors.lastname: Shovlin
authors.affiliation: c Medical Oncology Branch, Center for Cancer Research , National Cancer Institute , Bethesda , MD , USA.
authors.forename: Tito
authors.initials: T
authors.lastname: Fojo
authors.affiliation: a Lymphoid Malignancy Branch, Center for Cancer Research , National Cancer Institute , Bethesda , MD , USA ;
authors.forename: Wyndham H
authors.initials: WH
authors.lastname: Wilson
mesh_terms: D000328:Adult; D058846:Antibodies, Monoclonal, Murine-Derived / Q000009:adverse effects / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects* / Q000627:therapeutic use; D015415:Biomarkers; D003520:Cyclophosphamide / Q000009:adverse effects / Q000627:therapeutic use; D004317:Doxorubicin / Q000009:adverse effects / Q000627:therapeutic use; D005047:Etoposide / Q000009:adverse effects / Q000627:therapeutic use; D005260:Female; D005298:Fertility / Q000187:drug effects*; D005500:Follow-Up Studies; D012739:Gonadal Steroid Hormones / Q000097:blood; D006801:Humans; D016393:Lymphoma, B-Cell / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology*; D008479:Mediastinal Neoplasms / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology*; D008598:Menstruation / Q000187:drug effects; D008875:Middle Aged; D011241:Prednisone / Q000009:adverse effects / Q000627:therapeutic use; D011247:Pregnancy; D011256:Pregnancy Outcome; D000069283:Rituximab / Q000008:administration & dosage; D014750:Vincristine / Q000009:adverse effects / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D015415:Biomarkers; D012739:Gonadal Steroid Hormones; C571759:R-CHOP protocol; D000069283:Rituximab; D014750:Vincristine; D005047:Etoposide; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone
keywords: Aggressive B-cell lymphoma; DA-EPOCH-R; fertility; fertility following chemotherapy; primary mediastinal B-cell lymphoma