The risk for premature ovarian failure among female Hodgkin’s lymphoma survivors was less than 5% among those who were treated with non-alkylating chemotherapies, according to study results.
Data for the analysis were culled from the Life Situation Questionnaire, which was sent to 1,700 women aged 15 to 40 years who were treated in European Organization for Research and Treatment of Cancer and Groupe d'Étude des Lymphomes de l'Adulte trials from 1964 to 2004.
The aim was to estimate how different treatment regimens affect premature ovarian failure occurrence and motherhood. Evaluable outcomes included safety of non-alkylating chemotherapy, dose-response relationships for alkylating chemotherapy and age at treatment.
The researchers selected 460 women who were not currently using hormonal contraceptives to assess occurrence of premature ovarian failure. The life-table method was used to evaluate for cumulative premature ovarian failure risk, and regression analysis was used to determine predictive factors.
Patients were followed for a median of 16 years (range, 5-45 years).
Alkylating chemotherapy was linked to a cumulative premature ovarian failure risk of 60% (95% CI, 41-79) vs. a 3% (95% CI, 1-7) risk associated with non-alkylating chemotherapies. Two of the non-alkylating therapies were doxorubicin, bleomycin, vinblastine and dacarbazine, and epirubicin, bleomycin, vinblastine and prednisone.
A linear dose relationship was observed between alkylating chemotherapy and premature ovarian failure occurrence. The risk for premature ovarian failure increased by 23% for each year of age at treatment, according to the results.
The cumulative premature ovarian failure risk for women treated without alkylating chemotherapy aged younger than 32 years was 3% (95% CI, 1-16) vs. a 9% (95% CI, 4-18) risk among women aged at least 32 years who were treated without alkylating chemotherapy.
The cumulative premature ovarian failure risk was independent of age at treatment among women who began menstruating again after therapy.
Twenty-two percent of women who ultimately developed premature ovarian failure had one or more children after treatment. Among women who did not develop premature ovarian failure, 41% had one or more children after treatment.
“Timely family planning is important for women at risk of [premature ovarian failure],” the researchers wrote.