Fertility in male patients with advanced Hodgkin lymphoma treated with BEACOPP: a report of the German Hodgkin Study Group (GHSG)

Abstract

To date, there is little information on the impact of more aggressive treatment regimen such as BEACOPP (bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone) on the fertility of male patients with Hodgkin lymphoma (HL). We evaluated the impact of BEACOPP regimen on fertility status in 38 male patients with advanced-stage HL enrolled into trials of the German Hodgkin Study Group (GHSG). Before treatment, 6 (23%) patients had normozoospermia and 20 (77%) patients had dysspermia. After treatment, 34 (89%) patients had azoospermia, 4 (11%) had other dysspermia, and no patients had normozoospermia. There was no difference in azoospermia rate between patients treated with BEACOPP baseline and those given BEACOPP escalated (93% vs 87%, respectively; P > .999). After treatment, most of patients (93%) had abnormal values of follicle-stimulating hormone, whereas the number of patients with abnormal levels of testosterone and luteinizing hormone was less pro-

Current survivorship recommendations for patients with Hodgkin lymphoma: focus on late effects

“…Both escalated and baseline BEACOPP, regimens developed by the GHSG for patients with advanced HL, are associated with a risk of azoospermia in over 90% of male HL patients. 35 Half of women who received escalated BEACOPP reported continuous amenorrhea in one study, and the risk is significantly associated with advanced-stage disease, age over 30 at treatment, and lack of oral contraceptive use during treatment. However, the risk of amenorrhea was lower with baseline BEACOPP.…”

Management of fertility in patients treated for Hodgkin's lymphoma

“…There is no difference between baseline BEACOPP and escalated BEACOPP. 24 After COPP/ ABVD, the infertility rate is between 60 and 91% and varies depending on the number of treatment courses. After ABVD, the infertility rate is 0-8%, and after chemotherapy and pelvic radiotherapy an infertility rate of 2-11% has been reported.…”

Hodgkin Lymphoma Version 1.2017, NCCN Clinical Practice Guidelines in Oncology

“…40 The guidelines recommend fertility preservation (semen cryopreservation in male patients, ovarian tissue or oocyte cryopreservation in female patients) before the initiation of chemotherapy with alkylating agents or pelvic RT. 41,42 Oophoropexy should be considered to preserve ovarian function in premenopausal women if pelvic RT is contemplated.…”