Survivorship and Patients Perspective
Francesco Gaudio1, Claudia Nardelli2, Tommasina Perrone1, Filomena Emanuela Laddaga3, Giorgina Specchia1
1 Haematology, Policlinico Hospital, Bari, Italy, 2 Pathophysiology of Human Reproduction and Gametes Cryopreservation, Policlinico Hospital, Bari, Italy, 3 Pathology, Policlinico Hospital, Bari, Italy
As the number of survivors of young female Hodgkin's lymphoma (HL) increases, it is becoming more common to manage the pregnancies of women who have a history of exposure to chemotherapies and radiation therapy. Many patients and clinicians are worried that pregnancy after the diagnosis of HL may increase the risk of relapse, despite a lack of empirical evidence to support such concerns.
In the present study we included 77 women who received a diagnosis of HL between 2006 and 2015 and who were younger than 40 years of age and were in complete remission and alive without relapse > 2 years after treatment.
Among the 77 women with HL, 37 (48%) were nulliparous throughout follow-up, 32 (42%) were parous but had no pregnancies during follow-up, and 8 (10%) had a pregnancy during follow-up.
13 (17%) tried to become pregnant; 5/13 (39%) without success; 8/13 (61%) women became pregnant with the birth of eight healthy children.
The overall pregnancy rate was 10%. The median time from the end of the therapy to pregnancy was 50 months (range 25–72 months) and the cumulative incidence of pregnancy at 70 months was 39% Median age at pregnancy was 27 years (range 20–37 years).
In total, 2 relapses occurred during follow-up: none occurred in woman with a recent pregnancy Women exposed to a recent pregnancy had a relapse rate lower than that of women without exposure, although this difference was not statistically significant.
Conclusion: We found no evidence of significant impairment of the fertility of female HL long term survivors and no evidence that a pregnancy increases the relapse rate among women whose HL is in remission. Survivors of HL need to consider a range of factors when deciding about future reproduction.