Survivorship and Patients Perspective
Francesco Gaudio1, Claudia Nardelli2, Tommasina Perrone1, Filomena Emanuela Laddaga3, Giorgina Specchia1
1Haematology, Policlinico Hospital, Bari, Italy,2Pathophysiology of Human Reproduction and Gametes Cryopreservation, Policlinico Hospital, Bari, Italy,3Pathology, 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.