Differences in hematotoxicity between male and female patients with Hodgkin lymphoma and other malignancies

Abstract

With improved treatment strategies and prognosis for patients with Hodgkin lymphoma (HL), interest has increasingly focused on high-risk groups. These groups include a small proportion of patients who experience relapse or who have primary refractory disease despite state-of-the-art treatment. Although many research efforts have been made in this field, specific biological markers that reliably predict unfavorable outcome during first-line treatment are lacking. Recent analyses in HL and other malignancies, however, have demonstrated an important impact of patient-related factors, such as individual differences in hematologic toxicity and drug metabolism, on disease outcome. A different cytochrome enzyme status and slower drug clearance in female patients, resulting in higher systemic toxicity and effectiveness of treatment, indicate that sex-specific aspects are important. In this Review, we discuss the current data on hematotoxicity among male and female patients with HL and other malignancies. In addition, we highlight the potential causes of hematotoxicity and its impact on treatment outcome and the role of future strategies.

Brentuximab vedotin in the treatment of paediatric patients with relapsed or refractory Hodgkin's lymphoma: Results of a real‐life study

“…When severe, the reduction of BV dose allowed patients to complete treatment until the 16th scheduled dose. Although it was previously published that the development of side effects in HL patients receiving chemotherapy could be correlated with sex, 24 no correlation between BV and sex was observed in our case series. The development of serious infections like herpes infection and pneumonia was a clinical issue assessed during our study.…”

Outcomes of First-Line Chemotherapy in Patients with Advanced or Metastatic Leiomyosarcoma of Uterine and Non-Uterine Origin

“…This seemingly worse outcome for males with LMS, which adversely affects the outcomes of the whole group with non-uterine LMS, is in line with studies in tumor types other than STS also reporting worse outcomes for males. It is postulated that this may be due to differences in body mass index and composition and differences in drug pharmacodynamics and drug metabolism [ 31 ].…”

Gender medicine and oncology: report and consensus of an ESMO workshop

“…In experimental models, ERb activation inhibits lymphoma growth, vascularization, and dissemination [100]. Furthermore, differences in drug metabolism, with impact on toxicity and efficacy, are likely: sex differences in the haematologic toxicity of chemotherapy for HL have been reviewed elsewhere [101]. Low acute haematological toxicity, which is significantly more frequent in men (44% versus 19%, P < 0.00001), predicts disease recurrence, and male sex is an independent negative prognostic factor in HL [96,102].…”