Abstract
Hodgkin’s lymphoma occurs frequently in younger age. Fertility preservation is an important issue as survival rates are very high and some of the treatments are highly gonadotoxic.
Two relevant chemotherapy protocols are performed in Hodgkin’s lymphoma: ABVD and escalated BEACOPP. Some patients also receive local radiotherapy. Risk of amenorrhoea is >20% in women ≥30 years receiving any escalated BEACOPP therapy, and in women <30 years receiving ≥6 cycles escalated BEACOPP. Oligospermia can be detected among male patients independent of chemotherapy regimens and radiation. Azoospermia depends on intensity of the chemotherapy regimen. Therefore, women and men who are treated with these regimens should be advised to undergo fertility preservation therapy. The treatments which can be offered are freezing of oocytes, freezing of ovarian tissue and GnRHa, alone or in combination, as well as freezing of sperm or testicular tissue.
Keywords
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Sant M, Allemani C, Tereanu C, De Angelis R, Capocaccia R, Visser O, et al. Incidence of hematologic malignancies in Europe by morphologic subtype: results of the HAEMACARE project. Blood. 2010;116(19):3724–34. https://doi.org/10.1182/blood-2010-05-282632.
Robert-Koch-Institut (2016). 3.28 Morbus Hodgkin. Krebs Deutschl. 122–5.
von Wolff M, Bruckner T, Strowitzki TGA. Fertility preservation: ovarian response to freeze oocytes is not affected by different malignant diseases-an analysis of 992 stimulations. J Assist Reprod Genet. 2018;35(9):1713–9.
Glimelius I, Ekberg S, Jerkeman M, Chang ET, Björkholm M, Andersson TML, et al. Long-term survival in young and middle-aged Hodgkin lymphoma patients in Sweden 1992-2009-trends in cure proportions by clinical characteristics. Am J Hematol. 2015;90(12):1128–34. https://doi.org/10.1002/ajh.24184.
Pulte D, Jansen L, Gondos A, Emrich K, Holleczek B, Katalinic A, et al. Improved population level survival in younger Hodgkin lymphoma patients in Germany in the early twenty-first century. Br J Haematol. 2014;164(6):851–7. https://doi.org/10.1111/bjh.12722.
Skoetz N, Trelle S, Rancea M, Haverkamp H, Diehl V, Engert A, et al. Effect of initial treatment strategy on survival of patients with advanced-stage Hodgkin’s lymphoma: a systematic review and network meta-analysis. Lancet Oncol. 2013;14(10):943–52. https://doi.org/10.1016/S1470-2045(13)70341-3.
Behringer K, Goergen H, Hitz F, Zijlstra JM, Greil R, Markova J, et al. Omission of dacarbazine or bleomycin, or both, from the ABVD regimen in treatment of early-stage favourable Hodgkin’s lymphoma (GHSG HD13): an open-label, randomised, non-inferiority trial. Lancet. 2014;385(9976):1418–27. https://doi.org/10.1016/S0140-6736(14)61469-0.
Von Tresckow B, Plütschow A, Fuchs M, Klimm B, Markova J, Lohri A, et al. Dose-intensification in early unfavorable Hodgkin’s lymphoma: final analysis of the German Hodgkin study group HD14 trial. J Clin Oncol. 2012;30(9):907–13. https://doi.org/10.1200/JCO.2011.38.5807.
Engert A, Haverkamp H, Kobe C, Markova J, Renner C, Ho A, et al. Reduced-intensity chemotherapy and PET-guided radiotherapy in patients with advanced stage Hodgkin’s lymphoma (HD15 trial): a randomised, open-label, phase 3 non-inferiority trial. Lancet. 2012;379(9828):1791–9. https://doi.org/10.1016/S0140-6736(11)61940-5.
S3-Leitlinie Diagnostik, Therapie und Nachsorge des Hodgkin Lymphoms bei erwachsenen. Patienten. 2019: 1–183.
van Beek RD, Smit M, van den Heuvel-Eibrink MM, de Jong FH, Hakvoort-Cammel FG, van den Bos C, et al. Inhibin B is superior to FSH as a serum marker for spermatogenesis in men treated for Hodgkin’s lymphoma with chemotherapy during childhood. Hum Reprod. 2007;22(12):3215–22. https://doi.org/10.1093/humrep/dem313.
Kiserud CE, Fosså A, Bjøro T, Holte H, Cvancarova M, Fosså SD. Gonadal function in male patients after treatment for malignant lymphomas, with emphasis on chemotherapy. Br J Cancer. 2009;10:455–63. https://doi.org/10.1038/sj.bjc.6604892.
Kulkarni S, et al. Gonadal function following ABVD therapy for Hodgkin‘ s disease. Am J Clin Oncol. 1997;20(4):354–7.
Behringer K, Breuer K, Reineke T, May M, Nogova L, Klimm B. Secondary amenorrhea after Hodgkin’s lymphoma is influenced by age at treatment, stage of disease, chemotherapy regimen, and the use of oral contraceptives during therapy: a report from the German Hodgkin’s lymphoma study group. J Clin Oncol. 2005;23(30):7555–64. https://doi.org/10.1200/JCO.2005.08.138.
Behringer K, Mueller H, Goergen H, Thielen I, Eibl AD, Stumpf V, et al. Gonadal function and fertility in survivors after Hodgkin lymphoma treatment within the German Hodgkin study group HD13 to HD15 trials. J Clin Oncol. 2013;31(2):231–9. https://doi.org/10.1200/JCO.2012.44.3721.
Weibull CE, Eloranta S, Smedby KE, Bjorkholm M, Kristinsson SY, Johansson AL, et al. Pregnancy and the risk of relapse in patients diagnosed with Hodgkin lymphoma. J Clin Oncol. 2016;34(4):337–44. https://doi.org/10.1200/JCO.2015.63.3446.
Caponecchia L, Cimino G, Sacchetto R, Fiori C, Sebastianelli A, Salacone P, et al. Do malignant diseases affect semen quality? Sperm parameters of men with cancers. Andrologia. 2016;48(3):333–40.
Paoli D, Rizzo F, Fiore G, Pallotti F, Pulsoni A, Annechini G, et al. Spermatogenesis in Hodgkin’s lymphoma patients: a retrospective study of semen quality before and after different chemotherapy regimens. Hum Reprod. 2016;31(2):263–72. https://doi.org/10.1093/humrep/dev310.
Seshadri T, Gook D, Lade S, Spencer A, Grigg A, Tiedemann K, et al. Lack of evidence of disease contamination in ovarian tissue harvested for cryopreservation from patients with Hodgkin lymphoma and analysis of factors predictive of oocyte yield. Br J Cancer. 2006;94(7):1007–10. https://doi.org/10.1038/sj.bjc.6603050.
Meirow D, Hardan I, Dor J, Fridman E, Elizur S, Ra’anani H, et al. Searching for evidence of disease and malignant cell contamination in ovarian tissue stored from hematologic cancer patients. Hum Reprod. 2008;23(5):1007–13. https://doi.org/10.1093/humrep/den055.
Bittinger SE, Nazaretian SP, Gook DA, Parmar C, Harrup RA, Stern CJ. Detection of Hodgkin lymphoma within ovarian tissue. Fertil Steril. 2011;95(2):803e3–6. https://doi.org/10.1016/j.fertnstert.2010.07.1068.
Hoekman EJ, Smit VTHBM, Fleming TP, Louwe LA, Fleuren GJ, CGJM H. Searching for metastases in ovarian tissue before autotransplantation: a tailor-made approach. Fertil Steril. 2015;103(2):469–77. https://doi.org/10.1016/j.fertnstert.2014.11.001.
Lekovich J, Lobel ALS, Stewart JD, Pereira N, Kligman I, Rosenwaks Z. Female patients with lymphoma demonstrate diminished ovarian reserve even before initiation of chemotherapy when compared with healthy controls and patients with other malignancies. J Assist Reprod Genet. 2016;33(5):657–62. https://doi.org/10.1007/s10815-016-0689-1.
Lawrenz B, Fehm T, Von Wolff M, Soekler M, Huebner S, Henes J, et al. Reduced pretreatment ovarian reserve in premenopausal female patients with Hodgkin lymphoma or non-Hodgkin-lymphoma—evaluation by using antimüllerian hormone and retrieved oocytes. Fertil Steril. 2012;98(1):141–4. https://doi.org/10.1016/j.fertnstert.2012.04.021.
Liebenthron J, Reinsberg J, van der Ven K, Saenger N, Kruessel JS, von Wolff M. Serum anti-Mullerian hormone concentration and follicle density throughout reproductive life and in different diseases—implications in fertility preservation. Hum Reprod. 2019;34(12):2513–22. https://doi.org/10.1093/humrep/dez215.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2020 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Bürkle, C., von Wolff, M., Behringer, K. (2020). Hodgkin’s Lymphoma. In: von Wolff, M., Nawroth, F. (eds) Fertility Preservation in Oncological and Non-Oncological Diseases. Springer, Cham. https://doi.org/10.1007/978-3-030-47568-0_7
Download citation
DOI: https://doi.org/10.1007/978-3-030-47568-0_7
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-47567-3
Online ISBN: 978-3-030-47568-0
eBook Packages: MedicineMedicine (R0)