(ChemotherapyAdvisor) – Survivors of Hodgkin lymphoma had significantly fewer children after treatment than matched population controls, a difference that “concerned only patients who already had children before treatment and was larger in females than in males,” investigators reported in the Journal of Clinical Oncology online September 24.
The chance of successful parenthood following treatment was 76%, noted Hanneke C. Kluin-Nelemans, MD, PhD, University of Groningen, Groningen, the Netherlands, and colleagues.
The European Organisation for Research and Treatment of Cancer (EORTC) Lymphoma Group and Groupe d’Etude des Lymphomes de l’Adulte (GELA) study administered a Life Situation Questionnaire to 3,604 survivors of Hodgkin lymphoma treated from 1964 to 2004 in clinical trials. A total of 1,654 French and Dutch survivors were subsequently matched with 6,414 controls.
For survivors compared with controls, the odds ratio for having children was 0.77 (95% CI, 0.68 to 0.87; P<0.001) at a median follow-up of 14 years (range 5-44).
“Of 898 survivors who were childless before treatment, 46.7% achieved posttreatment parenthood compared with 49.3% of 3,196 childless controls (OR 0.87; P=0.08),” they stated.
Among 756 survivors with children before treatment, 12.4% became parents after HL treatment compared with 22.2% of 3,218 controls with children before treatment (OR 0.49; P<0.001).
The likelihood of spontaneous posttreatment parenthood was reduced by treatment with alkylating agents, second-line therapy, and age older than 35 years at treatment.
“We documented that nonresponders had more likely been treated with nonalkylating chemotherapy and radiotherapy above the diaphragm only,” they wrote. “This may contribute to an underestimation of parenthood probability in our survivors.
“However, given that our results found no differences between patients and controls without children before treatment, this potential underestimation is unlikely to influence our conclusions.”