Survivorship and Patients Perspective
Maria Fernanda Evangelista Simões, Gilnara Fontinelle Silva, Thaís Rodrigues da Cunha Fischer, Carlos Sérgio Chiattone, Sergio Costa Fortier, Talita Máira Bueno da Silveira da Rocha
Santa Casa de Misericórdia de São Paulo
Introduction: The most frequently first line protocol for Hodgkin's lymphoma (HL) is ABVD. This protocol is considered to be highly effective and has a safety profile because of lower morbidity and toxicity. Another protocol option is BEACOPP, a more intensive regimen, usually used for advanced stage disease. In both regimens, there are late drug-related side effects such as secondary neoplasms, cardiovascular diseases and infertility.
The objective of this study is to evaluate fertility after first line therapy in patients with HL followed at Santa Casa de São Paulo. We also aim to describe this cohort sociodemographic characteristics.
Methods: This is a prospective study in which data were collected from medical chart and further interviews regarding fertility was performed.
Results: We interviewed 41 patients diagnosed with HL from between January 1990 and July 2016 that have completed treatment until August 2016. In this group, the mean age was 32 years old; 39% were caucasian; 51.2% were married and 56.1% had completed high school education. 47% of these patients waged 2–4 minimum-salary income monthly, data with no statistical significance in fertility rates.
Regarding HL, 87.8% were nodular sclerosis subtype, 53.8% were stage I-II and 80% have been submitted to ABVD protocol as first-line therapy.
Almost half of patients (51%) had no children; 34.1% of patients had sexual intercourse without contraceptive methods in order to become pregnant; and 71% of those who intended to become pregnant had children.
Fertility analysis of these HL patients demonstrate rate of 0.97 child/woman, lower than data in the literature. Although, 71.4% of the women who had sexual intercourse with intention of becoming pregnant without the use of contraceptives were successful. The difference in fertility rate may be due to emotional issues that led to a lower number of women wishing to become pregnant after treatment, or due to a reduction of the fertile period because of HL treatment time, whereas treatment did not appear to have an impact on fertility.
Conclusion: HL treatment on female fertility still bring significant morbidity. Studies to assess the fertility of this population are still needed as well as biological markers.