ABVD and BEACOPP regimens’ effects on fertility in young males with Hodgkin lymphoma

Abstract

Purpose Considering the increased cancer patient survivorship, the focus is now on addressing the impacts of treatment on quality of life. In young people, altered reproductive function is a major issue and its effects in young males are largely neglected by novel research. To improve clinician awareness, we systematically reviewed side effects of chemotherapy for Hodgkin lymphoma (HL) in young males. Methods The review was prospectively registered (PROSPERO N. CRD42019122868). Three databases (Medline via PUBMED, SCOPUS, and Cochrane Library) were searched for studies featuring males aged 13-51-years who underwent chemotherapy for HL using ABVD (Adriamycin® (doxorubicin), bleomycin, vinblastine, and dacarbazine) or BEACOPP (bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisolone) regimens. These chemotherapy regimens were compared against each other using sperm characteristics, FSH, and inhibin B levels to measure fertility levels. Results Data were extracted from five studies featuring 1344 patients. 6 months post-ABVD saw marked deterioration in sperm count, further reduced by more cycles (P = 0.05). Patients treated with BEACOPP rather than ABVD were more prone to oligospermia. Receiving fewer cycles of both regimens increased the likelihood of sperm production recovering. Patients treated with 6-8 cycles of BEACOPP did not recover spermiogenesis. Conclusions ABVD and BEACOPP regimens significantly reduce fertility function to varying effects depending on treatment duration. ABVD temporarily causes significant reductions in male fertility, whereas BEACOPP’s effects are more permanent. Therefore, clinicians should discuss fertility preservation with male patients receiving infertility-inducing gonadotoxic therapy. Further high-quality studies are required to more adequality describe the risk to fertility by chemotherapy.

Vincristine in Combination Therapy of Cancer: Emerging Trends in Clinics

“…ABVD or BEACOPP regimens alone are very effective against blood cancer malignancies, yet, their further development is still needed. Evidence suggests that these regimens could negatively impact the fertility of both male and female patients [ 100 , 101 ]. In addition, Ramos et al reported that the ABVD regimen induces genomic chaos after one year of the treatment.…”

Incorporating Reproductive Health in the Clinical Management of Early-Onset Colorectal Cancer

“…11 Gonadotoxicity and sexual dysfunction are welldocumented for patients with cancer across other tumor types (eg, lymphoma, breast, and germ cell). [12][13][14][15][16][17][18][19][20] However, the population of patients with early-onset CRC differs as rates of sexual dysfunction are higher in CRC (across all age groups, including early-onset CRC) compared with all cancer survivors. 21 This is because of altering physiology as a result of CRC-specific therapies-pelvic radiation, abdominoperineal resection, mesorectal surgery, and cytotoxic chemotherapies.…”

Review of Treatment Options for the Management of Advanced Stage Hodgkin Lymphoma

“…After this regimen, the recovery time of spermatogenesis in men was also much longer. Young patients treated with BEACOPP should be informed of its high gonadotoxicity and directed to a specialist to discuss protective methods to preserve fertility [14][15][16].…”