Although most female patients regain fertility after CHOP-like chemotherapy for aggressive lymphoma, late ovarian impairment occurs frequently in these patients, a new study published online in the journal Annals of Oncology has shown.

Results of the study showed that during a median follow-up of 14 years, late menstrual bleeding occurred significantly earlier in patients compared with the general population (47 years vs 51 years; P < 0.0001) and a higher percentage of patients experienced moderate to severe menopausal symptoms than the general population.

Laboratory analyses showed that anti-Muller-hormone (AMH) was decreased in patients when compared with correspondent age groups in the general population. AMH is a marker of ovarian reserve.

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For the study, researchers surveyed 46 long-term survivors of aggressive non-Hodgkin lymphoma who received CHOP or CHOP plus etoposide treatment within the Mabthera International Trial or the NHL B1 trial of the German NHL Study Group. Participants also underwent blood sampling for hormone replacement.

Chemotherapy-associated ovarian damage has been associated with alkylating chemotherapy for breast cancer or Hodgkin’s lymphoma, and can result in infertility and premature menopause.


  1. Meissner J, Tichy D, Katzke V, et al. Long-term ovarian function in women treated with CHOP or CHOP plus etoposide for aggressive lymphoma. Ann Oncol. 2015. [Epub ahead of print]. doi: 10.1093/annonc/mdv227.