Female Gonadal Toxicities after Treatment of Primary Hodgkin Lymphoma (HL). Analysis of the LENT-SOMA Questionnaire Registered in the Database of the German Hodgkin Study Group (GHSG).

Introduction:

As a consequence of the impressive long-term remission rates in Hodgkin Lymphoma (HL), the reduction of treatment-related complications is becoming increasingly important. The most important treatment-related toxicities are secondary malignancies, infertility, pulmonary, cardiac, and thyroid dysfunction. Here, we report results of the prospectively planned LENT-SOMA questionnaire to determine female gonadal toxicities in women successfully treated for HL.

Patients and methods:

Between 1998 and 2002, the GHSG has conducted the fourth generation of clinical trials for the treatment of early, intermediate and advanced stage HL (HD 10–12) involving a total of approximately 4000 evaluable patients. The LENT-SOMA questionnaire was sent out to the participating centers 2, 5 and 10 years after a patient’s randomisation to evaluate cardiac, pulmonary, and gonadal dysfunction after HL treatment. To focus on female gonadal toxicities, questions referred to the menstrual cycle, infertility, and osteoporosis.

Results:

Overall, approximately 1.900 (50%) LENT-SOMA questionnaire after 2 years were identified. A total of 568 questionnaire were evaluable for the question of menstrual cycle after therapy. Amenorrhea was most frequent in women with advanced stage after treatment with 8 cycles of escalated BEACOPP compared to treatment consisting of 4 cycles of escalated BEACOPP plus 4 cycles of BEACOPP baseline (45% vs. 19%, p<0.0001). A regular cycle was most commonly reported in women treated with two or four cycles of ABVD (98.8% and 95.9%). The frequency of gonadal dysfunction will be evaluated according to treatment modality (chemotherapy, chemo- and radiotherapy) and it will be analysed with respect to age.

Conclusion:

Female gonadal toxicities after HL treatment include amenorrhea, infertility and osteoporosis. The first analysis of the LENT-SOMA questionnaire focussing on female gonadal dysfunction will be presented.