No protection of the ovarian follicle pool with the use of GnRH-analogues or oral contraceptives in young women treated with escalated BEACOPP for advanced-stage Hodgkin lymphoma. Final results of a phase II trial from the German Hodgkin Study Group

Behringer, Karolin; Wildt, L.; Mueller, Horst; Mattle, Verena; Ganitis, P.; Hoonaard, B. van den; Ott, Helmut W.; Hofer, S; Pluetschow, Annette; Diehl, Volker; Engert, Andreas; Borchmann, Peter

doi:10.1093/annonc/mdq066

Cited by 154 publications

(112 citation statements)

References 44 publications

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“…These patients are in the greatest risk of chDOR and also other means of fertility preservation as oocyte/embryo or ovarian tissue cryopreservation should be offered to them prior initiation of chemotherapy, if possible. Our observations are consistent with previous studies that also indicated limited or no protection of the ovarian follicle pool with GnRH-a in young women treated with EB chemotherapy -regimen C in our study [13,17].…”

Section: Discussionsupporting

confidence: 93%

Fertility status of Hodgkin lymphoma patients treated with chemotherapy and adjuvant gonadotropin-releasing hormone analogues

Hüser

Šmardová

Janků

et al. 2015

J Assist Reprod Genet

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Purpose Aim of this prospective observational study was to analyze fertility status of Hodgkin lymphoma (HL) patients treated with different types of chemotherapy while receiving GnRH analogues to preserve ovarian function. Methods Fertility status was assessed among 108 females in reproductive age treated by curative chemotherapy for freshly diagnosed HL between 2005 and 2010 in university-based tertiary fertility and oncology center. All patients received GnRH analogues during chemotherapy to preserve their ovarian function. Their reproductive functions were assessed by follicle-stimulating hormone (FSH) measurement and pregnancy achievement. Ovarian function was determined separately in three groups with increasing gonadotoxicity of chemotherapy.Results One year following the treatment, normal ovarian function was found in 89 (82.4 %) of patients. Two years after chemotherapy, 98 (90.7 %) of patients retained their ovarian function, and 23 (21.3 %) achieved clinical pregnancy during the follow-up period. Average FSH after chemotherapy was 11.6±17.9 IU/l 1 year after the treatment resp. 9.0±13.8 at the 2 years interval. There were significantly more patients with chemotherapy induced diminished ovarian reserve (chDOR) among the group receiving escalated BEACOPP chemotherapy in comparison with the other types of treatment (58.1 % vs. 87.9 % resp. 95.5 %). Conclusion The rate of chDOR is significantly higher after EB poly-chemotherapy and there is no tendency for improvement in time. The 2+2 chemotherapy with GnRH-a required for more advanced HL retained ovarian function significantly better after 2 years. Another important advantage of GnRH-a co-treatment is the excellent control of patient's menstrual cycle.

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Section: Discussionsupporting

confidence: 93%

Fertility status of Hodgkin lymphoma patients treated with chemotherapy and adjuvant gonadotropin-releasing hormone analogues

Hüser

Šmardová

Janků

et al. 2015

J Assist Reprod Genet

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“…122 Some studies, including randomized trials, have evaluated the role of menstrual suppression with gonadotropin-releasing hormone (GnRH; also known as LH-releasing hormone [LHRH]) agonists to preserve ovarian function during chemotherapy. [123][124][125][126][127][128][129][130][131] Some meta-analyses have shown that GnRH agonist may be beneficial for fertility preservation. [132][133][134] However, the impact of these meta-analyses are limited by flaws such as only examining women with breast cancer and only including trials that were not adequately powered and did not use blinding and/ or a placebo condition.…”

Section: Options For Femalesmentioning

confidence: 99%

Adolescent and Young Adult Oncology, Version 2.2018, NCCN Clinical Practice Guidelines in Oncology

Coccia¹,

Pappo²,

Beaupin³

et al. 2018

J Natl Compr Canc Netw

261

194

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“…In addition, the authors noted that chemotherapy resulted in a similarly decreased ovarian reserve in both groups, as measured by inhibin B and anti-Mullerian hormone (AMH). The same conclusion was reached by another randomized trial in patients with Hodgkin lymphoma [27]. This study was prematurely closed when a 12-month interim analysis showed goserelin-treated patients having the same degree of acute and chronic insufficiency as women treated with oral contraceptives, as reflected by menstrual patterns and AMH and FSH measurements.…”

Section: Ovarian Suppressionmentioning

confidence: 73%

Applicability of adult techniques for ovarian preservation to childhood cancer patients

Detti

Williams

2012

J Assist Reprod Genet

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Purpose To appraise the feasibility of current adult medical and surgical techniques for ovarian preservation in prepubertal and adolescent girls with cancer. Methods Literature search using PubMed and SCOPUS up to February 2012. In addition, the reference lists of selected studies and all identified systematic and narrative reviews were scanned for relevant references. Inclusion criteria were ovarian preservation and cancer. Exclusion criteria were non-English publications, letters, personal communications, and ovarian preservation for conditions other than cancer. Results Data from the selected publications was interpreted and discussed in the relevant sections. Cryopreservation of ovarian tissue followed by autologous transplant represents the only surgical option available for pre-pubertal girls and adolescents who cannot delay the start of chemotherapy. Few studies report on pre-pubertal and adolescent girls undergoing ovarian preservation surgeries with good harvesting, and no follow-up has been conveyed, to date. Outcomes of ovarian function after ovarian suppression with GnRH-analogs in adults have been controversial and no reports are available for pre-pubertal girls. Conclusions Autologous transplantation of cryopreserved ovarian cortex probably represents the best option for preservation of fertility and hormonal function in childhood cancer females; however, future research needs to address the safety of this technique, especially in patients with blood-borne cancers. Ovarian suppression with GnRHanalogs at the time of chemotherapy treatment has not proven to be superior to non-suppression for fertility preservation purposes in adults. Not enough evidence is presently available in childhood cancer patients.

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No protection of the ovarian follicle pool with the use of GnRH-analogues or oral contraceptives in young women treated with escalated BEACOPP for advanced-stage Hodgkin lymphoma. Final results of a phase II trial from the German Hodgkin Study Group

Cited by 154 publications

References 44 publications

Fertility status of Hodgkin lymphoma patients treated with chemotherapy and adjuvant gonadotropin-releasing hormone analogues

Fertility status of Hodgkin lymphoma patients treated with chemotherapy and adjuvant gonadotropin-releasing hormone analogues

Adolescent and Young Adult Oncology, Version 2.2018, NCCN Clinical Practice Guidelines in Oncology

Applicability of adult techniques for ovarian preservation to childhood cancer patients

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