Impact of ABVD chemotherapy on ovarian reserve after fertility preservation in reproductive-aged women with Hodgkin lymphoma

Policiano, Catarina; Subirá, Jessica; Aguilar, Alejandra; Monzó, Susana; Iniesta, Ignacio; Rubio, José María Rubio

doi:10.1007/s10815-020-01844-0

Cited by 6 publications

(4 citation statements)

References 23 publications

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“…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.…”

Section: Combination Of Vincristine With Procarbazine or Dacarbazinementioning

confidence: 99%

Vincristine in Combination Therapy of Cancer: Emerging Trends in Clinics

Škubník

Pavlíčková

Ruml

et al. 2021

Biology

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Treatment of blood malignancies and other cancer diseases has been mostly unfeasible, so far. Therefore, novel treatment regimens should be developed and the currently used ones should be further elaborated. A stable component in various cancer treatment regimens consists of vincristine, an antimitotic compound of natural origin. Despite its strong anticancer activity, mostly, it cannot be administered as monotherapy due to its unspecific action and severe side effects. However, vincristine is suitable for combination therapy. Multidrug treatment regimens including vincristine are standardly applied in the therapy of non-Hodgkin lymphoma and other malignancies, in which it is combined with drugs of different mechanisms of action, mainly with DNA-interacting compounds (for example cyclophosphamide), or drugs interfering with DNA synthesis (for example methotrexate). Besides, co-administration of vincristine with monoclonal antibodies has also emerged, the typical example of which is the anti-CD20 antibody rituximab. Although in some combination anticancer therapies, vincristine has been replaced with other drugs exhibiting lesser side effects, though, in most cases, it is still irreplaceable. This is strongly evidenced by the number of active clinical trials evaluating vincristine in combination cancer therapy. Therefore, in this article, we have reviewed the most common cancer treatment regimens employing vincristine and bring an overview of current trends in the clinical development of this compound.

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Section: Combination Of Vincristine With Procarbazine or Dacarbazinementioning

confidence: 99%

Vincristine in Combination Therapy of Cancer: Emerging Trends in Clinics

Škubník

Pavlíčková

Ruml

et al. 2021

Biology

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“…In both studies, none of the patients had received pelvic radiotherapy. Three additional papers (89 patients) reported a significant decrease in AMH before and after treatment for HL ( Krawczuk-Rybak et al , 2013a ; Berjeb et al , 2020 ; Policiano et al , 2020 ). A summary of results is presented in Table I and Supplementary Fig.…”

Section: Resultsmentioning

confidence: 99%

“…Only the paper by Policiano et al (2020) reported AFC in HL survivors, and they mentioned a decrease in AFC post-treatment in comparison to values pre-treatment after a follow-up of ±2.8 years (44 patients, pre-treatment AFC 19 (interquartile range (IQR) 14–23), and post-treatment 10 (IQR 7–15), P value not given). Patients with an AFC below 6 or serum AMH below 0.84 ng/ml at baseline were excluded from this study.…”

Section: Resultsmentioning

confidence: 99%

Reproductive ability in survivors of childhood, adolescent, and young adult Hodgkin lymphoma: a review

Drechsel

Pilon

Stoutjesdijk

et al. 2023

Human Reproduction Update

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BACKGROUND Owing to a growing number of young and adolescent Hodgkin lymphoma (HL) survivors, awareness of (long-term) adverse effects of anticancer treatment increases. The risk of impaired reproductive ability is of great concern given its impact on quality of life. There is currently no review available on fertility after childhood HL treatment. OBJECTIVE AND RATIONALE The aim of this narrative review was to summarize existing literature on different aspects of reproductive function in male and female childhood, adolescent, and young adult HL survivors. SEARCH METHODS PubMed and EMBASE were searched for articles evaluating fertility in both male and female HL survivors aged <25 years at diagnosis. In females, anti-Müllerian hormone (AMH), antral follicle count, premature ovarian insufficiency (POI), acute ovarian failure, menstrual cycle, FSH, and pregnancy/live births were evaluated. In males, semen-analysis, serum FSH, inhibin B, LH, testosterone, and reports on pregnancy/live births were included. There was profound heterogeneity among studies and a lack of control groups; therefore, no meta-analyses could be performed. Results were presented descriptively and the quality of studies was not assessed individually. OUTCOMES After screening, 75 articles reporting on reproductive markers in childhood or adolescent HL survivors were included. Forty-one papers reported on 5057 female HL survivors. The incidence of POI was 6–34% (median 9%; seven studies). Signs of diminished ovarian reserve or impaired ovarian function were frequently seen (low AMH 55–59%; median 57%; two studies. elevated FSH 17–100%; median 53%; seven studies). Most survivors had regular menstrual cycles. Fifty-one studies assessed fertility in 1903 male HL survivors. Post-treatment azoospermia was highly prevalent (33–100%; median 75%; 29 studies). Long-term follow-up data were limited, but reports on recovery of semen up to 12 years post-treatment exist. FSH levels were often elevated with low inhibin B (elevated FSH 0–100%; median 51.5%; 26 studies. low inhibin B 19–50%; median 45%; three studies). LH and testosterone levels were less evidently affected (elevated LH 0–57%, median 17%; 21 studies and low testosterone 0–43%; median 6%; 15 studies). In both sexes, impaired reproductive ability was associated with a higher dose of cumulative chemotherapeutic agents and pelvic radiotherapy. The presence of abnormal markers before treatment indicated that the disease itself may also negatively affect reproductive function (Females: AMH<p10 9%; one study and Males: azoospermia 0–50%; median 10%; six studies). Reports on chance to achieve pregnancy during survivorship are reassuring, although studies had their limitations and the results are difficult to evaluate. In the end, a diminished ovarian reserve does not exclude the chance of a live birth, and males with aberrant markers may still be able to conceive. WIDER IMPLICATIONS This review substantiates the negative effect of HL treatment on gonadal function and therefore young HL survivors should be counseled regarding their future reproductive life, and fertility preservation should be considered. The current level of evidence is insufficient and additional trials on the effects of HL and (current) treatment regimens on reproductive function are needed. In this review, we make a recommendation on reproductive markers that could be assessed and the timing of (repeated) measurements.

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“…In particular, one of their most common effects is gonadal toxicity. Although therapies against HL are effective, they may contribute to fertility damage of patients inducing temporary or irreversible loss of fertility (Melo et al, 2019, Policiano et al, 2020. Due to chemotherapy and radiotherapy women affected by HL are exposed to an increased risk of early menopause and ovarian follicle depletion (Morgan et al, 2012).…”

Section: Introductionmentioning

confidence: 99%

Molecular profiling of follicular fluid microRNAs in young women affected by Hodgkin lymphoma

Caponnetto

Battaglia

Ragusa

et al. 2021

Reproductive BioMedicine Online

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Research question: Therapies for Hodgkin Lymphoma (HL) have improved in the last few years but one of their common effects is gonadal toxicity that contributes to fertility damage of patients inducing temporary or irreversible loss of fertility. Could miRNA expression profiles in Follicular Fluid (FF) be influenced by HL? Could their alteration have an impact on molecular pathways involved in follicle growth and oocyte maturation? Design: In this study, miRNA expression profile was investigated in FF samples from young women affected by HL with respect to healthy controls by NanoString technology. Bioinformatic analysis was performed to verify miRNA involvement in follicle development and miRNA deregulation with HL in a larger cohort of FF samples was confirmed by RT-qPCR. Results: 13 miRNAs are dysregulated in HL samples with respect to controls and are involved in molecular pathways related to cancer, gametogenesis and embryogenesis. Among them, let-7b-5p, miR-423-5p, miR-503-5p, miR-574-5p and miR-1303 are implicated in biological processes related to follicle development and oocyte maturation. Let-7b-5p holds the central position in the regulatory network of miRNA-mRNA interactions, has the highest number of mRNA target genes shared with the other DE miRNAs and is significantly down-regulated in HL FF samples. Conclusions: These data represent the first molecular analysis on FF of young women with HL and led us to wonder about the potential influence of miRNA deregulation on oocyte quality. Further studies are needed to verify the reproductive potential of young patients with HL before starting chemotherapy protocols and provide them with a guarantee of an adequate protocol of fertility preservation.

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Impact of ABVD chemotherapy on ovarian reserve after fertility preservation in reproductive-aged women with Hodgkin lymphoma

Cited by 6 publications

References 23 publications

Vincristine in Combination Therapy of Cancer: Emerging Trends in Clinics

Vincristine in Combination Therapy of Cancer: Emerging Trends in Clinics

Reproductive ability in survivors of childhood, adolescent, and young adult Hodgkin lymphoma: a review

Molecular profiling of follicular fluid microRNAs in young women affected by Hodgkin lymphoma

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