Elsevier

Annals of Oncology

Volume 19, Issue 10, October 2008, Pages 1795-1801
Annals of Oncology

original articles
supportive care
Assessment of male fertility in patients with Hodgkin's lymphoma treated in the German Hodgkin Study Group (GHSG) clinical trials

https://doi.org/10.1093/annonc/mdn376Get rights and content
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Abstract

Background

Infertility is one of the most significant side-effects in long-term survivors of successfully treated Hodgkin's lymphoma (HL).

Patients and methods

The fertility status was assessed in male HL patients enrolled into trials of the German Hodgkin Study Group from 1988 to 2003.

Results

In pre-treatment analysis (n = 202), 20% of patients had normozoospermia, 11% azoospermia and 69% had other dyspermia. In post-treatment analysis (n = 112), 64% of patients had azoospermia, 30% other dyspermia and 6% normozoospermia (P < 0.001). Azoospermia was observed in 90% of patients treated with chemotherapy alone, 67% of those treated with combined modality and 11% of those treated with radiotherapy alone (P < 0.001). Azoospermia was more frequent after 4× cyclophosphamide, vincristine, procarbazine, prednisone, doxorubicin, bleomycin, vinblastine, dacarbazine (COPP/ABVD) (91%), 8× bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, prednisone (BEACOPP) baseline (93%) and 8× BEACOPP escalated (87%) compared with 2× COPP/ABVD (56%; P = 0.003). There was a statistically significant difference in post-treatment follicle-stimulating hormone (FSH) levels between patients with azoospermia and those with preserved spermatogenesis (P = 0.001).

Conclusions

Depending on the treatment received, male HL patients are at high risk of infertility after treatment. FSH might be used as surrogate parameter for male fertility in future studies.

Keywords

chemotherapy
follicle-stimulating hormone
Hodgkin's lymphoma
male fertility

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